Rural Health
Resources by Topic: Hospitals
Evaluation of the Rural Community Hospital Demonstration: CCA Extension Final Report (Covering 2016-2021)
Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Nursing Homes Failed to Report 43 Percent of Falls With Major Injury and Hospitalization among Their Medicare-Enrolled Residents
Explores the extent to which falls with major injury that resulted in hospitalization among Medicare-enrolled nursing home residents were accurately reported by nursing homes in Minimum Data Set (MDS) assessments between July 2022 and June 2023. Compares the nursing home and patient characteristics associated with higher rates of unreported falls, including nursing home size, ownership structure, rurality, and overall star rating.
Additional links: Report Highlights
Date: 09/2025
Sponsoring organization: Office of Inspector General (HHS)
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Explores the extent to which falls with major injury that resulted in hospitalization among Medicare-enrolled nursing home residents were accurately reported by nursing homes in Minimum Data Set (MDS) assessments between July 2022 and June 2023. Compares the nursing home and patient characteristics associated with higher rates of unreported falls, including nursing home size, ownership structure, rurality, and overall star rating.
Additional links: Report Highlights
Date: 09/2025
Sponsoring organization: Office of Inspector General (HHS)
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Hospital Trends in the Use, Evaluation, and Governance of Predictive AI, 2023-2024
Describes trends in the foundational use, evaluation, and governance of predictive artificial intelligence (AI) in hospitals using data from the 2023 and 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the differences in acute care hospitals' use of predictive AI by hospital size, CAH status, rural/urban location, independent/system affiliation, and electronic health record (EHR) vendor.
Date: 09/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Describes trends in the foundational use, evaluation, and governance of predictive artificial intelligence (AI) in hospitals using data from the 2023 and 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the differences in acute care hospitals' use of predictive AI by hospital size, CAH status, rural/urban location, independent/system affiliation, and electronic health record (EHR) vendor.
Date: 09/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule
Comments offered in response to a July 17, 2025, proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment Systems for calendar year 2026. Discusses proposals for the Hospital Outpatient Quality Reporting (OQR), Rural Emergency Hospital Quality Program (REHQR), and Ambulatory Surgical Center Quality Reporting (ASCQR) Programs.
Date: 09/2025
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Comments offered in response to a July 17, 2025, proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Payment Systems for calendar year 2026. Discusses proposals for the Hospital Outpatient Quality Reporting (OQR), Rural Emergency Hospital Quality Program (REHQR), and Ambulatory Surgical Center Quality Reporting (ASCQR) Programs.
Date: 09/2025
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Tax-Exempt Hospitals Provided Nearly $149 Billion in Total Benefits to Their Communities
Summarizes the benefits nonprofit hospitals provide their communities based on an analysis of IRS Form 990 Schedule H. Addresses the percent spent on financial assistance, health professions education, medical research, community building activities, and other categories included on Schedule H. Includes data for rural and Critical Access Hospitals.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Summarizes the benefits nonprofit hospitals provide their communities based on an analysis of IRS Form 990 Schedule H. Addresses the percent spent on financial assistance, health professions education, medical research, community building activities, and other categories included on Schedule H. Includes data for rural and Critical Access Hospitals.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Sustaining Rural Labor & Delivery Programs: Strategies for Financial Analyses and Considerations for Maintaining Services
A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Rural Resource: Availability of Obstetric Simulation Training by State
Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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September 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare payment operations and improving payment accuracy, a discussion with the Comptroller General of the United States regarding the Government Accountability Office's work related to improper payments in the Medicare program and opportunities to improve program sustainability, Medicare's overall financial situation, access to hospice and services under the Medicare hospice benefit for beneficiaries with end-stage renal disease or cancer, and the relationship between changes in Medicare Advantage enrollment and hospital finances.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare payment operations and improving payment accuracy, a discussion with the Comptroller General of the United States regarding the Government Accountability Office's work related to improper payments in the Medicare program and opportunities to improve program sustainability, Medicare's overall financial situation, access to hospice and services under the Medicare hospice benefit for beneficiaries with end-stage renal disease or cancer, and the relationship between changes in Medicare Advantage enrollment and hospital finances.
Date: 09/2025
Sponsoring organization: Medicare Payment Advisory Commission
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An Evaluation of State Flex Program Initiatives to Support Critical Access Hospital-Based Rural Health Clinics
Describes the 16 State Flex Program (SFP) Critical Access Hospital (CAH)-based Rural Health Clinic (RHC) initiatives for the 2023-2024 funding year. Explores the various strategies SFPs have employed to assist CAH-based RHCs by highlighting common activities, challenges, and successes observed across their programs. Summarizes interviews with seven SFPs identifying common themes and notable variations in how they engage with CAH-based RHCs.
Author(s): Bridget Harr, Rebecca Stearns, John Gale
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Describes the 16 State Flex Program (SFP) Critical Access Hospital (CAH)-based Rural Health Clinic (RHC) initiatives for the 2023-2024 funding year. Explores the various strategies SFPs have employed to assist CAH-based RHCs by highlighting common activities, challenges, and successes observed across their programs. Summarizes interviews with seven SFPs identifying common themes and notable variations in how they engage with CAH-based RHCs.
Author(s): Bridget Harr, Rebecca Stearns, John Gale
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Comparison of Care in Hospital Outpatient Departments and Independent Physician Offices: Updated Findings for 2019-2024
Examines differences in Medicare payments for services at an independent physician's office (IPO) or a hospital outpatient department (HOPD). Utilizes 2019-2024 data to analyze characteristics of Medicare patients seen in HOPDs and IPOs, including rural versus urban location.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Examines differences in Medicare payments for services at an independent physician's office (IPO) or a hospital outpatient department (HOPD). Utilizes 2019-2024 data to analyze characteristics of Medicare patients seen in HOPDs and IPOs, including rural versus urban location.
Date: 09/2025
Sponsoring organization: American Hospital Association
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