Rural Health
Resources by Topic: Sole Community Hospitals
Fast Facts on U.S. Hospitals, 2025
Offers resources highlighting data from the American Hospital Association (AHA) Annual Survey. Provides data on the number of hospitals by type, ownership, system-affiliated versus independent, and rural versus urban location. Includes an interactive map of community hospitals in the United States.
Additional links: Infographics from Fast Facts on U.S. Hospitals, 2025
Date: 2025
Sponsoring organization: American Hospital Association
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Offers resources highlighting data from the American Hospital Association (AHA) Annual Survey. Provides data on the number of hospitals by type, ownership, system-affiliated versus independent, and rural versus urban location. Includes an interactive map of community hospitals in the United States.
Additional links: Infographics from Fast Facts on U.S. Hospitals, 2025
Date: 2025
Sponsoring organization: American Hospital Association
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Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 10/2024
Sponsoring organization: Medicare Payment Advisory Commission
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2018‐23 Profitability of Rural and Urban Hospitals by Medicare Payment Designation
Examines the profitability of rural and urban hospitals according to special Medicare payment designations, including: Critical Access Hospitals (CAHs), Prospective Payment System (PPS) hospitals, Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), Rural Referral Centers (RRCs), and Essential Access Community Hospitals (EAC). Utilizes 2018-2023 data to analyze hospital profitability by rural versus urban status and facility/payment type.
Author(s): Sruthi Malavika Srinivasan, Kristie Thompson, George Pink
Date: 06/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Examines the profitability of rural and urban hospitals according to special Medicare payment designations, including: Critical Access Hospitals (CAHs), Prospective Payment System (PPS) hospitals, Medicare Dependent Hospitals (MDHs), Sole Community Hospitals (SCHs), Rural Referral Centers (RRCs), and Essential Access Community Hospitals (EAC). Utilizes 2018-2023 data to analyze hospital profitability by rural versus urban status and facility/payment type.
Author(s): Sruthi Malavika Srinivasan, Kristie Thompson, George Pink
Date: 06/2024
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Payment for Rural or Geographically Isolated Hospitals
Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Sponsoring organization: Congressional Research Service
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Displays data on Medicare payment adjustments for Sole Community Hospitals, Medicare-Dependent Hospitals, Low-Volume Hospitals, and Critical Access Hospitals. Includes information on the number of qualifying hospitals by state and eligibility criteria.
Date: 04/2024
Sponsoring organization: Congressional Research Service
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Oregon Rural Hospitals
Shows a county-level map of Oregon identifying the location of rural hospitals including Critical Access Hospitals (CAHs), non-CAHs, and sole community hospitals.
Date: 03/2024
Sponsoring organization: Oregon Office of Rural Health
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Shows a county-level map of Oregon identifying the location of rural hospitals including Critical Access Hospitals (CAHs), non-CAHs, and sole community hospitals.
Date: 03/2024
Sponsoring organization: Oregon Office of Rural Health
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Characteristics of Short-Term Acute Care Hospitals That Experienced a Ransomware Attack from 2016 to 2021
Analyzed short-term acute care hospitals experiencing a ransomware attack between 2016 and 2019 to identify characteristics associated with an attack. Considered variables such as rurality, various financial characteristics, information technology infrastructure, and more. Includes recommendation for future research regarding rural impacts.
Author(s): Claire C. McGlave, Sayeh S. Nikpay, Carrie Henning-Smith, Katie Rydberg, Hannah T. Neprash
Citation: Health Affairs Scholar, 1(3)
Date: 09/2023
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Analyzed short-term acute care hospitals experiencing a ransomware attack between 2016 and 2019 to identify characteristics associated with an attack. Considered variables such as rurality, various financial characteristics, information technology infrastructure, and more. Includes recommendation for future research regarding rural impacts.
Author(s): Claire C. McGlave, Sayeh S. Nikpay, Carrie Henning-Smith, Katie Rydberg, Hannah T. Neprash
Citation: Health Affairs Scholar, 1(3)
Date: 09/2023
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Closed, Converted, Merged, and New Hospitals with Medicare Rural Designations: January 2018-November 2022
Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Provides an overview of four Medicare rural hospital designations - Critical Access Hospital, Low-Volume Hospital, Medicare Dependent Hospital, and Sole Community Hospital - and factors related to financial distress that these designations are intended to address. Explores the number of rural-designated hospitals that have closed, merged, converted, or opened between January 2018-November 2022 and compares the number of rural-designated hospitals with the number of non-designated hospitals. Outlines considerations for Congress regarding policy options for rural hospitals and access to healthcare services in rural areas.
Date: 04/2023
Sponsoring organization: Congressional Research Service
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Analysis of Hospital Operating Margins and Provision of Safety Net Services
Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Explores the association between five hospital safety net services - undercompensated care measured using the Disproportionate Share Hospital index, uncompensated care, essential community services, and Sole Community Hospital and Critical Access Hospital status - and hospital operating margins. Includes information on the relationship between bed count, Census region, urban/rural location, ownership status, and having a Graduate Medical Education residency program with operating margins.
Author(s): Lukas K. Gaffney, Kenneth A. Michelson
Citation: JAMA Network Open, 6(4), e238785
Date: 04/2023
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Types of Rural and Urban Hospitals and Counties Where They Are Located
Offers a snapshot of the types of rural and urban hospitals and the counties where they are located. Presents data on the number and percent of acute care hospitals and average daily census by hospital type, special payment designation, and county size. Includes descriptions of Medicare special payment designations for hospitals.
Date: 07/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Offers a snapshot of the types of rural and urban hospitals and the counties where they are located. Presents data on the number and percent of acute care hospitals and average daily census by hospital type, special payment designation, and county size. Includes descriptions of Medicare special payment designations for hospitals.
Date: 07/2022
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Covers a Lower Percentage of Outpatient Costs in Hospitals Located in Rural Areas
Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Policy brief describing differences in Medicare Outpatient Prospective Payment System (OPPS) payments between urban and rural hospitals. Features statistics on OPPS payments as a percent of total net patient revenue, as a percent of Medicare outpatient cost by hospital payment classification, and as a percent of Medicare outpatient cost by number of acute beds, with breakdowns by urban and rural location.
Author(s): Pranathi Sana, George H. Pink
Date: 09/2021
Sponsoring organization: North Carolina Rural Health Research Program
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