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Rural Health Information Hub

Rural Health
Resources by Topic: Healthcare business and finance

An Updated Model of Rural Hospital Financial Distress
Discusses a potential model to predict financial distress in rural hospitals, including negative cash flow margin, negative equity, or closure of facility. Tests 2,311 rural hospitals from 2013 to 2019 with the model and discusses its potential to predict financial distress and create accurate assessments.
Author(s): Tyler L. Malone, George H. Pink, George M. Holmes
Citation: Journal of Rural Health, 41(2)
Date: 2025
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Drive Time to Care and Retention in HIV Care: Rural–Urban Differences Among Medicaid Enrollees in the United States South
Presents a study on the role geography plays in HIV care retention and maintenance. Draws data from Medicaid enrollees in 13 southern states including the District of Columbia and compares patient drive times to care in rural and urban areas. Breaks down data by county social determinants of health, healthcare supply, and HIV prevalence, as well as patient characteristics.
Author(s): April D. Kimmel, Rose S. Bono, Zhongzhe Pan, et al.
Citation: Journal of Rural Health, 41(1), e12877
Date: 2025
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The Uneven Impact of Medicaid Expansion on Rural and Urban Black, Latino/a, and White Mortality
Examines mortality rates and the corresponding impact of Medicaid expansion on Black, Latino/a, and White populations, broken down by rural versus urban location. Utilizes 2009-2019 data of Average Treatment Effect on the Treated (ATET) estimates to provide statistical breakdowns and graphic representation of how Medicaid expansion has impacted mortality rates for varying populations.
Author(s): J. Tom Mueller, Regina S. Baker, Matthew M. Brooks
Citation: Journal of Rural Health, 41(1), e12859
Date: 2025
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CMS Office of Minority Health: Health Equity Data Book
Provides data on disparities in participation in Centers for Medicare & Medicaid Services (CMS) programs, including data on demographics of covered individuals, chronic conditions, behavioral health conditions, and social determinants of health. Contains rural data for select programs.
Date: 12/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Behavioral Health Service Use among Individuals Enrolled in Medicaid and CHIP Before and During The COVID-19 Public Health Emergency
Examines behavioral health (BH) service usage changes among Medicaid and Children's Health Insurance Program (CHIP) enrollees during the COVID-19 public health emergency (PHE). Compares BH service initiation and treatment before the PHE (2018-2019) and during the PHE (2019-2020), with further data breakdowns by enrollee BH condition and demographic variables, including rural versus urban location.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Texas Medicaid and CHIP Reference Guide: Fifteenth Edition
Reference guide for aspects of Texas's Medicaid and Children's Health Insurance Program (CHIP) programs, including caseload and costs, eligibility and enrollment, available services, program administration, and quality of care. Features information on rural-specific policies for reimbursement, time and distance standards, the Rural Access to Primary Care and Preventive Services Program, rural hospitals, Rural Health Clinics (RHCs), and Federally Qualified Health Centers (FQHCs).
Date: 12/2024
Sponsoring organization: Texas Health and Human Services
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The Implications of the No Surprises Act on Contract Dynamics, Negotiations, and Finances
Provides feedback from insurance and healthcare stakeholders regarding the No Surprises Act (NSA), with a focus on insurer-provider dynamics, insurer and provider staffing, contract negotiations, payment rates, and the handling of advanced explanation of benefits (AEOB) provisions. Provides 2024 interview feedback from 35 stakeholders regarding the NSA and includes reflections on its impact for rural and underserved communities.
Author(s): Petra W. Rasmussen, Erin Lindsey Duffy, Isha Yardi, et al.
Date: 12/2024
Sponsoring organization: RAND Corporation
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Texas Medicaid Managed Care Provider Network Adequacy Report, 2024
Reports information and statistics on managed care organizations (MCOs) and their obligations to provide access to services for Medicaid members in Texas. Discusses MCO contractual obligations and performance related to geography throughout, with breakdowns by metro, micro, and rural area.
Date: 12/2024
Sponsoring organization: Texas Health and Human Services
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Financial Performance Gaps Between Critical Access Hospitals and Other Acute Care Hospitals
Research letter examining how system affiliation impacted hospital financial measures for Critical Access Hospitals (CAHs) and non-CAHs between 2020 and 2022.
Author(s): Christopher Whaley, Marilyn Bartlett, Ge Bai
Citation: JAMA Health Forum, 5(12)
Date: 12/2024
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Medicaid Behavioral Health Providers Delivering Most Behavioral Health Services via Telehealth Before and During the COVID-19 Pandemic Issue Brief
Examines the extent to which Medicaid behavioral health providers shifted their practices to mostly telebehavioral health services during the COVID-19 pandemic through December 2021. Explores differences between specialty and non-specialty behavioral health providers, providers serving enrollees with mental health conditions versus substance use disorders, and rural and urban providers.
Date: 12/2024
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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