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Resources by Topic: Rural Emergency Hospitals

Orientation to Rural Emergency Hospital Conversion and Technical Assistance
Recording of a January 18, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, and REH Technical Assistance Center (TAC) services. Transcript available by clicking the dots above the video description, then selecting Show transcript.
Additional links: Presentation Slides
Date: 01/2023
Type: Document
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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Characteristics of Rural Hospitals Eligible for Conversion to Rural Emergency Hospitals and Three Rural Hospitals Considering Conversion
Findings brief presenting updated data for Rural Emergency Hospital (REH)-eligible hospitals. Compares financial and operational measures of 3 rural hospitals that have expressed interest in REH conversion with those of all 1,787 REH-eligible hospitals. Also discusses what factors may determine the number of rural hospitals that convert to REH, including risk of permanent closure.
Author(s): George Pink, Susie Gurzenda, Kristie Thompson, Ann Howard
Date: 12/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital
Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Small Rural Hospitals with Low-Volume Emergency Departments that May Convert to a Rural Emergency Hospital (REH)
Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Health Workforce Implications for the Rural Emergency Hospital Model
Describes workforce challenges hospitals converting to Rural Emergency Hospital status may experience. Discusses flexible staffing models, utilization of behavioral health providers, colocation of health and human services providers and team-based care, and recruitment and retention.
Author(s): Jacob Rains
Citation: Health Affairs Forefront
Date: 10/2022
Type: Document
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Health Panel Comment Letter – Hospital Outpatient Prospective Payment System and Rural Emergency Hospitals
Comments offered in response to a July 26, 2022, Federal Register proposed rule revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and establishing Rural Emergency Hospital (REH) payment policy, quality measures, and enrollment policy. Discusses telehealth services for mental healthcare; REH quality measures, telehealth, and Conditions of Participation; and the use of Centers for Medicare & Medicaid Services (CMS) data on hospital and skilled nursing facilities changes in ownership.
Date: 09/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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