Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Measuring State Flex Program Impact: Tools to Support Outcome Measurement and Evaluation
Toolkit designed to help State Flex Programs (SFPs) with manage and document project performance and comply with the Federal Office of Rural Health Policy's expectations regarding outcome measurement and reporting. Provides blank worksheets for SFPs as they work through the steps for their projects, as well as links to outcome measurement resources.
Additional links: Webinar Recording
Author(s): John Gale, Bridget Harr
Date: 12/2025
Sponsoring organization: Flex Monitoring Team
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Toolkit designed to help State Flex Programs (SFPs) with manage and document project performance and comply with the Federal Office of Rural Health Policy's expectations regarding outcome measurement and reporting. Provides blank worksheets for SFPs as they work through the steps for their projects, as well as links to outcome measurement resources.
Additional links: Webinar Recording
Author(s): John Gale, Bridget Harr
Date: 12/2025
Sponsoring organization: Flex Monitoring Team
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RHCs and CAHs Participating in the Medicare Shared Savings Program (MSSP): Characteristics of the Providers and Communities
Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Describes the characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) currently participating in the Medicare Shared Savings Program (MSSP) in 2023. Compares CAH and RHC characteristics by MSSP participation, ownership status, and free-standing versus provider-based RHC status.
Author(s): Edmer Lazaro, Dan Shane, Fred Ullrich, Keith Mueller
Date: 11/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Facilitators of Strong Quality and Financial Outcomes in Critical Access Hospitals
Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines leadership traits, management strategies, and other governance and collaboration-based supports for positive quality and financial outcomes in Critical Access Hospitals (CAHs), utilizing insights from interviews of leaders at 10 CAHs which met high financial and quality benchmarks. Provides interview excerpts and identifies themes.
Author(s): Robert Barclay, Zoe Pringle, Megan Lahr, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Characteristics of Critical Access Hospitals with High Financial and Quality Metric Performance
Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolving Role of Critical Access Hospitals in Rural Physician Training
Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 10/2025
Sponsoring organization: Flex Monitoring Team
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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 10/2025
Sponsoring organization: Flex Monitoring Team
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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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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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Last Updated: 12/2/2025