Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Sliding Fee Scale Discount Guide for CAHs and RHCs
Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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Provides concepts and guidance to help Critical Access Hospital (CAH) and Rural Health Clinic (RHC) executives and management teams develop a sliding fee scale discount program. Addresses how these programs relate to Internal Revenue Code Section 501(r) compliance and participation in the National Health Service Corps (NHSC). Includes an example of a sliding fee schedule.
Date: 04/2022
Sponsoring organization: National Rural Health Resource Center
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An Inventory of State Flex Program Population Health Initiatives for Fiscal Years 2019-2023
Provides an overview of Medicare Rural Hospital Flexibility (Flex) Program funding for initiatives to improve rural population health under Program Area 3: Population Health Improvement. Offers a state-by-state summary of State Flex Program (SFP) population health initiatives between fiscal years 2019 and 2021. Details output and process measures, outcome measures, and SFP partners for each initiative.
Author(s): Celia Jewell, Sara Kahn-Troster, Zachariah Croll, John Gale
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Provides an overview of Medicare Rural Hospital Flexibility (Flex) Program funding for initiatives to improve rural population health under Program Area 3: Population Health Improvement. Offers a state-by-state summary of State Flex Program (SFP) population health initiatives between fiscal years 2019 and 2021. Details output and process measures, outcome measures, and SFP partners for each initiative.
Author(s): Celia Jewell, Sara Kahn-Troster, Zachariah Croll, John Gale
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Evaluating State Flex Program Population Health Activities
Provides an overview of the expectations for the Medicare Rural Hospital Flexibility (Flex) Program under Program Area 3: Population Health Improvement and summarizes State Flex Program (SFP) initiatives under this program area. Describes promising population health strategies implemented by SFPs and challenges to measuring the impact of these activities. Explores how Flex Program population health efforts can align with the U.S. Department of Health and Human Services' Healthy Rural Hometown Initiative (HRHI).
Author(s): John Gale, Celia Jewell, Sara Kahn-Troster, Zachariah Croll
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Provides an overview of the expectations for the Medicare Rural Hospital Flexibility (Flex) Program under Program Area 3: Population Health Improvement and summarizes State Flex Program (SFP) initiatives under this program area. Describes promising population health strategies implemented by SFPs and challenges to measuring the impact of these activities. Explores how Flex Program population health efforts can align with the U.S. Department of Health and Human Services' Healthy Rural Hometown Initiative (HRHI).
Author(s): John Gale, Celia Jewell, Sara Kahn-Troster, Zachariah Croll
Date: 03/2022
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospital Financial and Operational Best Practices
Webinar recording that discusses rural hospital operations, with a focus on Critical Access Hospitals (CAHs). Covers inpatient services, emergency services, quality improvement, managing revenue cycle, and other financial topics. Transcript is available in the video description.
Date: 01/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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Webinar recording that discusses rural hospital operations, with a focus on Critical Access Hospitals (CAHs). Covers inpatient services, emergency services, quality improvement, managing revenue cycle, and other financial topics. Transcript is available in the video description.
Date: 01/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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The Clinical and Business Cases for Opening a Maternity Care Unit in a CAH
A case study of a rural North Carolina partnership that worked together to add a new wing for a maternity unit at a 25-bed Critical Access Hospital. Explains how the service was planned to be financially viable. Describes maternal and infant health disparities in the region and discusses how this new service will meet the needs of patients.
Date: 01/2022
Sponsoring organization: American Hospital Association
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A case study of a rural North Carolina partnership that worked together to add a new wing for a maternity unit at a 25-bed Critical Access Hospital. Explains how the service was planned to be financially viable. Describes maternal and infant health disparities in the region and discusses how this new service will meet the needs of patients.
Date: 01/2022
Sponsoring organization: American Hospital Association
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Ending Surprise Medical Bills
Offers resources for healthcare providers and consumers regarding surprise billing regulations and policies. Includes information on payment dispute resolution between patients and providers, and between providers and out-of-network health plans.
Date: 2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Offers resources for healthcare providers and consumers regarding surprise billing regulations and policies. Includes information on payment dispute resolution between patients and providers, and between providers and out-of-network health plans.
Date: 2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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Examining Rural Hospital Bypass for Outpatient Services
Explores the drivers of rural hospital bypass for outpatient services and the relationship between hospital outpatient services and inpatient utilization. Examines demographic and market characteristics associated with bypass for outpatient services before and after inpatient admissions. Also analyzes how utilization for common outpatient services differs between Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals.
Date: 11/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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Explores the drivers of rural hospital bypass for outpatient services and the relationship between hospital outpatient services and inpatient utilization. Examines demographic and market characteristics associated with bypass for outpatient services before and after inpatient admissions. Also analyzes how utilization for common outpatient services differs between Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals.
Date: 11/2021
Sponsoring organization: Centers for Medicare and Medicaid Services
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How Critical Access Hospitals Are Addressing the Social Needs of Rural Populations
Describes Critical Access Hospital (CAH) initiatives that address the social needs of their communities. Summarizes interviews with 14 CAHs and identifies key facilitators and barriers to program success, as well as advice for other CAHs interested in implementing similar programs.
Author(s): Megan Lahr, Tongtan Chantarat, Mariah Quick, Madeleine Pick, Ira Moscovice
Date: 11/2021
Sponsoring organization: Flex Monitoring Team
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Describes Critical Access Hospital (CAH) initiatives that address the social needs of their communities. Summarizes interviews with 14 CAHs and identifies key facilitators and barriers to program success, as well as advice for other CAHs interested in implementing similar programs.
Author(s): Megan Lahr, Tongtan Chantarat, Mariah Quick, Madeleine Pick, Ira Moscovice
Date: 11/2021
Sponsoring organization: Flex Monitoring Team
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The Association Between System Affiliation and Financial Performance in Critical Access Hospitals
Examines the association between Critical Access Hospital (CAH) health system affiliation and financial performance as measured by the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Discusses trends in health system affiliation as an alternative to closures as well as potential downsides of affiliation.
Author(s): Laura Bozovich, Kathleen Knocke, George Pink, Ann Howard, Kristin L. Reiter
Date: 10/2021
Sponsoring organization: Flex Monitoring Team
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Examines the association between Critical Access Hospital (CAH) health system affiliation and financial performance as measured by the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Discusses trends in health system affiliation as an alternative to closures as well as potential downsides of affiliation.
Author(s): Laura Bozovich, Kathleen Knocke, George Pink, Ann Howard, Kristin L. Reiter
Date: 10/2021
Sponsoring organization: Flex Monitoring Team
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The Swing Bed Program: Impacting Patients, Providers, and Community
Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Brief video overview of the swing bed program, which helps rural hospitals provide patient- and community-centric post-acute healthcare. Describes the history, related policy issues, early implementation, and evolution of the program.
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Last Updated: 1/9/2026