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Rural Health Information Hub

Critical Access Hospitals (CAHs) – Resources

Selected recent or important resources focusing on Critical Access Hospitals (CAHs).

Unrelenting Pressure Pushes Rural Safety Net Crisis Into Uncharted Territory
Examines financial and operational metrics for rural hospitals. Discusses the growth of Medicare Advantage (MA) enrollment in rural communities between 2019 and 2023, the impact of MA on rural hospital reimbursement, how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities, and the discontinuation of obstetrics and chemotherapy services at rural hospitals since 2011. Includes the percentage of rural hospitals in each state vulnerable to closure and nine factors significantly associated with rural hospital vulnerability.
Date: 02/2024
Sponsoring organization: Chartis Center for Rural Health
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Critical Access Hospital Telehealth Guide
Provides practical guidance on implementing and sustaining telehealth in Critical Access Hospitals, to optimize healthcare delivery, expand access, and enhance care coordination. Focuses on Medicare outpatient telehealth services, but also includes information on Medicaid coverage and remote services that may not strictly be considered telehealth.
Date: 02/2024
Sponsoring organizations: National Rural Health Resource Center, Northwest Regional Telehealth Resource Center
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The State of Rural Healthcare: Research Report and Outlook for 2024
Presents results of a survey of 106 rural healthcare organizations across 25 states regarding their financial health and strategic priorities. Identifies the top challenges identified by the surveyed organizations. Discusses how providers are addressing three strategic priorities in 2024, including people management, revenue capture, and digital capabilities.
Date: 01/2024
Sponsoring organization: Wipfli, LLP
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2022 National and State Healthcare-Associated Infections Progress Report
Examines progress on reducing healthcare-associated infection rates for 6 types of infections in Acute Care Hospitals, Critical Access Hospitals, Inpatient Rehabilitation Facilities, and Long-term Acute Care Hospitals. Compares observed versus expected infection rates using 2015 baseline data. Includes national and state data tables on infection-specific standardized infection ratios (SIRs) and standardized utilization ratios (SURs) for each facility type.
Date: 11/2023
Sponsoring organization: Centers for Disease Control and Prevention
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Performance Management/Program Evaluation Guide: Medicare Rural Hospital Flexibility (Flex) Program
Offers guidance to state Flex program coordinators to incorporate performance management and evaluation into Flex program operations as required by the Flex Program Cooperative Agreement. Supports the state's capacity for assessing program activities, making improvements, and establishing if activities are effective. Defines key terms and concepts, discusses reporting requirements, demonstrates a performance year work plan, covers data collection, and provides examples of goals and measures to be included in the evaluation plan.
Additional links: Flex Program Glossary of Evaluation Terms, Quick List: Flex Program Evaluation Resources
Date: 10/2023
Sponsoring organization: National Rural Health Resource Center
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MBQIP Quality Measures National Annual Report - 2022
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Quality Time: Sharing PIE – Improving Swing Bed Quality
Podcast episode discussing how two Critical Access Hospital (CAH) quality improvement leaders in Mississippi and Nevada used proactive approaches to improve their swing bed programs. Describes efforts in reducing healthcare-associated infections with pneumonia and improving the documentation and coordination of swing bed patients.
Date: 09/2023
Sponsoring organization: Stratis Health
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Medicare Beneficiary Quality Improvement Project (MBQIP) Quality Reporting Guide
Offers Flex Coordinators, Critical Access Hospital staff, and others who are working with the Medicare Beneficiary Quality Improvement Project (MBQIP) information to better understand the measure reporting process. Discusses how to register for the reporting site, which measures are to be reported, and how to submit data for each measure. Groups measures by how and where the data is to be reported.
Date: 08/2023
Sponsoring organization: Stratis Health
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Quality Time: Sharing PIE – Preventing Readmissions
Podcast episode discussing the varied approaches used by quality leaders from three Critical Access Hospitals to reduce readmissions. Covers community partnerships and collaboration with local health and human services providers, including emergency medical services (EMS).
Date: 08/2023
Sponsoring organization: Stratis Health
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MBQIP Measures Fact Sheets
Discusses the federal data collection and reporting process for Medicare Beneficiary Quality Improvement Project (MBQIP) Core Measures and MBQIP Additional Measures to help Critical Access Hospitals (CAH) and state Flex Program personnel involved in quality improvement. The measures address patient safety, patient engagement, care transitions, and outpatient care.
Date: 08/2023
Sponsoring organization: Stratis Health
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Last Updated: 3/4/2025