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Rural Health
Resources by Topic: Hospitals

The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Sponsoring organization: North Carolina Rural Health Research Program
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CAH Partnerships During the COVID-19 Pandemic
Presents findings from a survey of Critical Access Hospitals (CAHs) in eight states on how they partnered with communities and public health agencies in response to the COVID-19 pandemic. Discusses the type of support CAHs received from their State Flex Program (SFP).
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Trends in the Utilization of Emergency Department Services, 2009-2018
Examines emergency department (ED) utilization. Explores ED visits resulting in hospital admission, visits ending in release, and visits associated with mental health or substance use disorder diagnoses. Presents information on the patient, hospital, and payer characteristics for each of these three categories, including metropolitan status. Describes federal efforts to discourage inappropriate ED use.
Date: 03/2021
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Monitoring State Flex Program Financial and Operational Improvement Activities
Presents the results of a qualitative evaluation of State Flex Program interventions implemented under Program Area 2: Financial and Operational Improvement (FOI). Describes the type of projects proposed by a subset of 14 State Flex Programs, key themes, and challenges faced to monitoring and documenting these interventions on financial and operational performance. Includes an inventory of all 45 State Flex Program FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Rural Initiatives Addressing Community Social Needs
Describes the role of Critical Access Hospitals (CAHs) in improving population health and addressing social needs in their communities. Profiles two Critical Access Hospital social needs programs: Lakewood Health System's food access initiatives in Minnesota, and Northeastern Vermont Regional Hospital's NEK Prosper. Provides an overview of both programs and highlights best practices of each.
Author(s): Madeleine Pick, Megan Lahr, Ira Moscovice
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospital Requirements: CMS Emergency Preparedness Final Rule
Provides a reference source for Critical Access Hospital (CAH) requirements related to the final rule from the Centers for Medicare & Medicaid Services (CMS), "Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers." Includes excerpts from the final rule as well as related CMS interpretive guidelines for CAHs. Addresses the development of an emergency plan, related policies and procedures, communications, training, and more.
Date: 03/2021
Sponsoring organization: Administration for Strategic Preparedness and Response
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Rural Hospital Patient and Family Engagement - 2021 Toolkit
Toolkit provides guidance for rural hospitals to foster effective communication between patients, staff, and leadership. Discusses communication strategies in a number of domains, such as data collection, community engagement, and workforce development, among others.
Date: 02/2021
Sponsoring organization: Colorado Hospital Association
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Opioid and Substance Use Strategies for Critical Access Hospitals
Recording of a February 26, 2021, webinar discussing the role of Critical Access Hospitals (CAHs) in addressing opioid and substance use disorders (O/SUDs) in local systems of care. Provides a framework to support CAH opioid and substance use initiatives. Highlights examples of O/SUD activities taken by CAHs and offers lessons learned.
Additional links: Presentation Slides
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Partnering to Improve Birth Outcomes in a Rural Community: Kearny County Hospital, Lakin, KS
Highlights the Pioneer Baby program, a partnership between Kearny County Hospital, a Critical Access Hospital in rural Lakin, Kansas, and the University of Kansas School of Medicine-Wichita. Discusses how funding from grants and local employers enhanced the obstetrics program. Describes how the partnership worked to improve pregnancy and birth outcomes and presents lessons learned.
Date: 02/2021
Sponsoring organization: American Hospital Association
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Medicare Reimbursement in Rural America
Policy brief discussing Medicare reimbursement for services provided at rural hospitals and how it impacts hospital finances. Provides policy recommendations for rural health reimbursement, and identifies and other considerations for addressing rural healthcare sustainability.
Author(s): Eric Schlidt, Cody Wilkinson
Date: 02/2021
Sponsoring organization: National Rural Health Association
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