Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1809-P)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; a proposal to include an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a proposal for new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) proposed rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; a proposal to include an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a proposal for new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 07/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
view details
Screening for Health-Related Social Needs: A Comparison of CAHs and Non-CAHs
Provides an overview of health-related social needs (HRSN) and social determinants of health (SDOH) and the impacts of screening for and collecting data on HRSN and SDOH. Analyzes 2022 American Hospital Association Annual Survey and Information Technology Supplement data to describe the collection of HRSN data among Critical Access Hospitals (CAHs). Compares the specific HRSNs assessed and programs to address HRSNs among CAHs and non-CAH hospitals. Presents data on the collection of HRSN data by CAHs by health system membership and electronic health record vendor. Describes the use of HRSN data by CAHs that routinely collect and do not routinely collect this data.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr, Robert Barclay
Date: 07/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Provides an overview of health-related social needs (HRSN) and social determinants of health (SDOH) and the impacts of screening for and collecting data on HRSN and SDOH. Analyzes 2022 American Hospital Association Annual Survey and Information Technology Supplement data to describe the collection of HRSN data among Critical Access Hospitals (CAHs). Compares the specific HRSNs assessed and programs to address HRSNs among CAHs and non-CAH hospitals. Presents data on the collection of HRSN data by CAHs by health system membership and electronic health record vendor. Describes the use of HRSN data by CAHs that routinely collect and do not routinely collect this data.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr, Robert Barclay
Date: 07/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
State Requirements for Demographic Data Reporting upon Hospital Discharge: An Overview for State Flex Programs
Summarizes results of an environmental scan of state-level policies regarding current state requirements regarding hospitals' collection and reporting of demographic data among 37 of the 45 states participating in the Medicare Rural Hospital Flexibility (Flex) Program. Describes requirements for sex, gender, and sexual orientation data; race, ethnicity, and language data; and other data and reporting, as well as variations in how categories are defined across states. Discusses challenges Critical Access Hospitals (CAHs) may face in meeting state requirements.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 05/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Summarizes results of an environmental scan of state-level policies regarding current state requirements regarding hospitals' collection and reporting of demographic data among 37 of the 45 states participating in the Medicare Rural Hospital Flexibility (Flex) Program. Describes requirements for sex, gender, and sexual orientation data; race, ethnicity, and language data; and other data and reporting, as well as variations in how categories are defined across states. Discusses challenges Critical Access Hospitals (CAHs) may face in meeting state requirements.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 05/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Rural Health Care: Supporting Lives and Improving Communities
Presents the U.S. Senate Committee on Finance May 16, 2024, hearing on rural healthcare. Discusses the financial vulnerability of rural hospitals, the rural healthcare workforce and graduate medical education (GME), access to maternal healthcare, health information technology and telehealth, and more. Features testimony from the Chartis Center for Rural Health; Grande Ronde Hospital, a Critical Access Hospital in Oregon; the Wisconsin Collaborative for Rural Graduate Medical Education; and the Rural Policy Research Institute.
Additional links: Jeremy P. Davis, Grande Ronde Hospital - Testimony, Keith J. Mueller, Rural Policy Research Institute - Testimony, Lori Rodefeld, Wisconsin Collaborative for Rural Graduate Medical Education - Testimony, Michael Topchik, Chartis Center for Rural Health - Testimony
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
view details
Presents the U.S. Senate Committee on Finance May 16, 2024, hearing on rural healthcare. Discusses the financial vulnerability of rural hospitals, the rural healthcare workforce and graduate medical education (GME), access to maternal healthcare, health information technology and telehealth, and more. Features testimony from the Chartis Center for Rural Health; Grande Ronde Hospital, a Critical Access Hospital in Oregon; the Wisconsin Collaborative for Rural Graduate Medical Education; and the Rural Policy Research Institute.
Additional links: Jeremy P. Davis, Grande Ronde Hospital - Testimony, Keith J. Mueller, Rural Policy Research Institute - Testimony, Lori Rodefeld, Wisconsin Collaborative for Rural Graduate Medical Education - Testimony, Michael Topchik, Chartis Center for Rural Health - Testimony
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
view details
Differences in Measurement of Operating Margin: An Update
Describes how differences in measurement of operating margin for hospitals can affect the reported values. Compares the operating margins of urban and rural prospective payment system hospitals and Critical Access Hospitals (CAHs) across three definitions of operating margin using Medicare Cost Report data from April 2021 through March 2022. Describes situations in which each operating margin would be the most appropriate to calculate. Updates a 2008 study from the Flex Monitoring Team.
Author(s): Jessie Ma, Susie Gurzenda, Kristin Reiter, George Pink
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
Describes how differences in measurement of operating margin for hospitals can affect the reported values. Compares the operating margins of urban and rural prospective payment system hospitals and Critical Access Hospitals (CAHs) across three definitions of operating margin using Medicare Cost Report data from April 2021 through March 2022. Describes situations in which each operating margin would be the most appropriate to calculate. Updates a 2008 study from the Flex Monitoring Team.
Author(s): Jessie Ma, Susie Gurzenda, Kristin Reiter, George Pink
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
National Health Service Corps Site Reference Guide
Provides clarification for National Health Service Corps (NHSC) sites regarding eligibility requirements, qualification factors, compliance, roles and responsibilities, and other factors for becoming an NHSC approved site. Acts as a supplemental resource to the information provided in the online NHSC Site Application.
Date: 05/2024
Type: Document
Sponsoring organization: Health Resources and Services Administration
view details
Provides clarification for National Health Service Corps (NHSC) sites regarding eligibility requirements, qualification factors, compliance, roles and responsibilities, and other factors for becoming an NHSC approved site. Acts as a supplemental resource to the information provided in the online NHSC Site Application.
Date: 05/2024
Type: Document
Sponsoring organization: Health Resources and Services Administration
view details
Critical Access Hospitals (CAHs)
Printable map that shows the location of Critical Access Hospitals (CAHs) nationwide by state. Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 05/2024
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
view details
Printable map that shows the location of Critical Access Hospitals (CAHs) nationwide by state. Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 05/2024
Type: Map/Mapping System
Sponsoring organization: Rural Health Information Hub
view details
Quality Improvement Workbook
Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 04/2024
Type: Document
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details
Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 04/2024
Type: Document
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details
Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
Describes the relative risk of rural hospitals and selected urban hospitals experiencing financial distress in 2023. Provides an overview of an updated Financial Distress Index (FDI), which incorporates variables reflecting changes to operational environments since the publication of the 2017 FDI to predict and analyze financial distress and risk of rural hospital closure. Presents data on the characteristics of hospitals by relative risk of financial distress in 2023 and the number of hospitals in each state across in category of relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
Describes the relative risk of rural hospitals and selected urban hospitals experiencing financial distress in 2023. Provides an overview of an updated Financial Distress Index (FDI), which incorporates variables reflecting changes to operational environments since the publication of the 2017 FDI to predict and analyze financial distress and risk of rural hospital closure. Presents data on the characteristics of hospitals by relative risk of financial distress in 2023 and the number of hospitals in each state across in category of relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Additional resources are available related to this guide. See the full list of resources by topic for:
Last Updated: 7/11/2024