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Rural Health
Resources by Topic: Sole Community Hospitals

Differences in Community Characteristics of Sole Community Hospitals
Findings brief presenting a snapshot of Sole Community Hospitals (SCHs) and their communities in 2015, and identifying trends in characteristics of selected SCHs and their communities from 2006 through 2015. Features statistics including breakdowns by large rural, small rural, and isolated rural location.
Author(s): Sharita R. Thomas, Mark Holmes, George H. Pink
Date: 11/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2017
Provides an overview of Medicare spending in addition to data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural to urban throughout.
Date: 06/2017
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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The Financial Importance of the Sole Community Hospital Payment Designation
Investigates the economic importance of the Sole Community Hospital (SCH) program by reviewing data between 2006 and 2015 regarding the proportion of SCHs reimbursed at the hospital-specific rate, and their profitability of providing services to Medicare patients. Also, discusses the economic consequences that would occur if the SCH program was not in operation in 2015.
Author(s): Sharita R. Thomas, Randy Randolph, G. Mark Holmes, George H. Pink
Date: 11/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
Compares the total margin and operating margin of rural and urban hospitals using 2012-2014 profitability data. Rural hospitals are divided by the size of the Prospective Payment System (the number of beds), and by the Medicare payment classification – Critical Access Hospitals (CAHs), Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), and Rural Referral Centers (RRCs).
Author(s): Sharita R. Thomas, G. Mark Holmes, George H. Pink
Date: 03/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Geographic Variation in the Profitability of Urban and Rural Hospitals
Analyzes and compares the 2014 profitability margins of rural and urban hospitals by census region, census division, and by state. Information on rural hospitals is broken down by Critical Access Hospitals (CAHs) and "other rural hospitals" (ORH), which includes Medicare Dependent Hospitals, Sole Community Hospitals, and rural PPS hospitals.
Author(s): Sharita R. Thomas, George H. Pink, G. Mark Holmes
Date: 03/2016
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Hospital Policy Issues: Statement by Mark Miller, Medicare Payment Advisory Commission before Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives
Testimony from the Medicare Payment Advisory Commission’s executive director presented at a July 22nd, 2015 Ways and Means subcommittee hearing concerning Medicare hospital payment issues, rural health issues, and beneficiary access to care. Discusses Medicare’s rural hospital payment adjustments, how they impact access to care, and principles to consider in evaluating rural add-on payments. Also discusses MedPAC recommendations related to graduate medical education (GME), including some related to rural training.
Author(s): Mark Miller, Medicare Payment Advisory Commission
Date: 07/2015
Type: Document
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Sole Community Hospitals: Early Indications Show That TRICARE's Revised Reimbursement Rules Have Not Affected Access to Care
Reports on the impact of a January 2014 revision to TRICARE’s reimbursement for Sole Community Hospitals (SCHs), which serve primarily rural areas. The new TRICARE reimbursement rules approximate Medicare’s for these hospitals. Looks at the impact of revised SCH reimbursement on healthcare access for servicemembers and their dependents. Findings based on claims data, as well as interviews with 10 SCHs and with national stakeholders. Appendices include information on SCHs with a high number of TRICARE admissions.
Date: 04/2015
Type: Document
Sponsoring organization: Government Accountability Office
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Do Current Medicare Rural Hospital Payment Systems Align with Cost Determinants?
Report discusses the various payment models that may affect the financial performance of rural hospitals and the variables (geographic, community, market, and hospital) that affect rural hospital costs.
Author(s): Kristin Moss, G. Mark Holmes, George H. Pink,
Date: 02/2015
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Hospital Outpatient Prospective Payment System: Payment System Fact Sheet Series
Provides information about the Hospital Outpatient Prospective Payment System, ambulatory payment classifications, and how payment rates are set. Includes information on the rural adjustment for Sole Community Hospitals.
Date: 12/2014
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Implications of Proposed Changes to Rural Hospital Payment Designations
Discusses the short-term policy implications of proposed changes to the designation and payment guidelines for small rural hospitals.
Date: 12/2012
Type: Document
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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