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Rural Health
Resources by Topic: Healthcare facilities

Projected Financial Losses Experienced by Community Health Centers under a Scenario of Major Cuts in Key Sources of Federal Funding: 2018-2022
Simulates the potential financial impacts on health centers and communities if the following congressional proposals are implemented: cuts to federal funding for Medicaid expansion, cuts to federal funding for Marketplace subsidies, and expiration of the Community Health Centers Fund. Also assesses the implications for other state and federal programs that may be required to help fill the resulting service and funding gaps.
Author(s): Avi Dor, Eric Luo, Ali Moghtaderi, Anne Rossier Markus
Date: 04/2017
Sponsoring organizations: Geiger Gibson Program in Community Health, George Washington University Milken Institute School of Public Health Department of Health Policy and Management, RCHN Community Health Foundation
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Finance in Rural and Urban Hospitals
Summary of the impact of the Affordable Care Act (ACA) on the insurance coverage rates and reimbursement methods in rural hospitals in Minnesota. Includes a discussion of public and private insurance programs, uncompensated care, and operating margins. Includes data and statistic comparisons for Critical Access Hospitals (CAHs), other rural hospitals, and urban hospitals.
Date: 04/2017
Sponsoring organization: Minnesota Department of Health - Office of Rural Health and Primary Care
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Designing a Health System That Works for the Tribe
Outlines the challenges facing the Rosebud Sioux Tribe as they work to restore services and improve quality in their Indian Health Service (IHS) hospital. Despite challenges leading to the closure of their emergency department and surgical and obstetrics wards, members of the Rosebud Sioux Tribe are exploring the option of hospital self-governance and believe a high quality healthcare system is within reach.
Author(s): Jessica Bylander
Citation: Health Affairs, 36(4), 592-595
Date: 04/2017
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How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data
Compares the impact of whether states decided to expand Medicaid on hospital finances, including an exploration of the impact on various types of hospitals. Examines and compares hospital financial indicators such as uncompensated care, Medicaid revenue, operating margin, and excess margins from fiscal year (FY) 2011 through FY 2015. Includes an extensive discussion on the variation between metro and nonmetro hospitals, and provides tables and charts to help illustrate trends.
Author(s): Fredric Blavin
Date: 04/2017
Sponsoring organizations: Robert Wood Johnson Foundation, Urban Institute
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Monroe County Hospital Achieving Outcomes
Examines the gains made by Monroe County Hospital, located in Monroeville, Alabama, as part of the Small Rural Hospital Transition project. During the project, the 35-bed prospective payment system (PPS) hospital focused on improving patient education and transitions of care, integrating pharmacists, implementing bedside reporting, and reducing readmission rates. The changes have resulted in improved community engagement and prepared MCH for value-based purchasing.
Date: 04/2017
Sponsoring organization: National Rural Health Resource Center
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Report to Congress on Medicaid and CHIP, March 2017
Reports on three aspects of Medicaid: Disproportionate Share Hospital (DSH) payments to states and providers, access to Medicaid, and children's coverage under CHIP. Chapter 2 includes the second annual report on DSH payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Table 2-1 identifies DSH spending for urban and rural hospitals and for Critical Access Hospitals. Chapter 3 examines state policies for distributing DSH payments to hospitals, including which states target rural or Critical Access Hospitals.
Date: 03/2017
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Medicaid Expansion, Budgetary Projections, and Impact on Hospitals
Examines the impact of Medicaid expansion in Louisiana on rural hospitals, healthcare providers, and the state budget. Addresses the potential impact on rural hospitals of a cutback in disproportionate share (DSH) payments for uncompensated care.
Author(s): James A. Richardson, Jared J. Llorens, Roy L. Heidelberg
Date: 03/2017
Sponsoring organization: Louisiana Public Health Institute
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Medicaid Expansion in Louisiana: Perspectives of Providers from Federally Qualified Health Centers and Rural Health Centers
Reports on interviews with Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in Louisiana to analyze the impact of Medicaid expansion. Describes the impact on health care access, changes made by FQHCs and RHCs, and the need for more healthcare providers.
Date: 03/2017
Sponsoring organization: Louisiana Public Health Institute
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Implementation and Outcomes of a Community-Based Pulmonary Rehabilitation Program in Rural Appalachia
Describes the implementation and outcomes of a community-based pulmonary rehabilitation program in rural Appalachia. Reports on data from three rural health centers and one large referral hospital for multiple measures, including pre- and post-exams, respiratory disease knowledge, smoking status, and more.
Author(s): Daniel Doyle, Chaffee Tommarello, Mike Broce, Mary Emmett, Cecil Pollard
Citation: Journal of Cardiopulmonary Rehabilitation and Prevention, 37(4), 295-298
Date: 03/2017
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Rural Hospital Environmental Impact Study
Examines the rapidly changing healthcare landscape, particularly as it relates to rural Texas, by focusing on four areas: the state of healthcare, rural hospital closures and vulnerabilities, the impact of the Affordable Care Act, and uninsurance rates. Presents information about the current and future state of healthcare in rural Texas to support rural health policymakers.
Date: 03/2017
Sponsoring organization: Texas Organization of Rural & Community Hospitals
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