Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Frontier Community Health Integration Project (FCHIP) Demonstration Extension Fact Sheet
Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Provides an overview of the Frontier Community Health Integration Project (FCHIP) Demonstration Extension, which tests new healthcare delivery models in the most sparsely populated rural counties. Identifies participating Critical Access Hospitals and models tested.
Date: 10/2024
Sponsoring organization: Centers for Medicare & Medicaid Services
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Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021
Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Sponsoring organization: Agency for Healthcare Research and Quality
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September 2024 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2024 meeting. Covers Medicare's overall financial situation, cost-sharing for outpatient services at Critical Access Hospitals, and experiences and challenges of measuring the quality of care provided by rural providers.
Additional links: Cost Sharing for Outpatient Services at Critical Access Hospitals - Presentation Slides, Medicare's Measurement of Rural Provider Quality - Presentation Slides
Date: 09/2024
Sponsoring organization: Medicare Payment Advisory Commission
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Workforce Toolkit to Support Critical Access Hospitals and Rural Providers
Toolkit intended to help Critical Access Hospitals (CAHs) and other rural providers improve workforce recruitment and retention efforts. Provides information on healthcare workforce challenges faced by CAHs. Offers examples of external resources that CAHs may utilize to address their workforce needs across four topics: organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce.
Date: 09/2024
Sponsoring organization: Flex Monitoring Team
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Toolkit intended to help Critical Access Hospitals (CAHs) and other rural providers improve workforce recruitment and retention efforts. Provides information on healthcare workforce challenges faced by CAHs. Offers examples of external resources that CAHs may utilize to address their workforce needs across four topics: organizational culture and leadership, leveraging partnerships, emergency medical services workforce, and administrative and support staff workforce.
Date: 09/2024
Sponsoring organization: Flex Monitoring Team
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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
Sponsoring organization: North Carolina Rural Health Research Program
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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
Sponsoring organization: North Carolina Rural Health Research Program
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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
Sponsoring organization: North Carolina Rural Health Research Program
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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
Sponsoring organization: North Carolina Rural Health Research Program
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Health Care Coalitions: A Resource to Support Critical Access Hospital Emergency Preparedness Planning
Describes unique challenges Critical Access Hospitals (CAHs) face regarding emergency preparedness planning. Presents findings from interviews with leaders from 8 statewide or regional healthcare coalitions (HCCs) regarding strategies and resources HCCs provide to support the CAH emergency preparedness planning process. Outlines the functions and roles of HCCs by the 4 Administration for Strategic Preparedness and Response (ASPR) capability goals.
Author(s): John Gale, Karen Pearson, Rebecca Stearns
Date: 04/2024
Sponsoring organization: Flex Monitoring Team
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Describes unique challenges Critical Access Hospitals (CAHs) face regarding emergency preparedness planning. Presents findings from interviews with leaders from 8 statewide or regional healthcare coalitions (HCCs) regarding strategies and resources HCCs provide to support the CAH emergency preparedness planning process. Outlines the functions and roles of HCCs by the 4 Administration for Strategic Preparedness and Response (ASPR) capability goals.
Author(s): John Gale, Karen Pearson, Rebecca Stearns
Date: 04/2024
Sponsoring organization: Flex Monitoring Team
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Community Impact and Benefit Activities of Critical Access, Other Rural, and Urban Hospitals, 2022
Examines the economic and healthcare benefit of Critical Access Hospitals (CAHs) on rural communities. Looks at the services provided, the economic health of CAHs, and the effect this has on their communities broadly. Includes comparisons of community benefit and patient care services indicators provided by CAHs and other rural and urban hospitals.
Author(s): Zachariah Croll, John Gale
Date: 03/2024
Sponsoring organization: Flex Monitoring Team
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Examines the economic and healthcare benefit of Critical Access Hospitals (CAHs) on rural communities. Looks at the services provided, the economic health of CAHs, and the effect this has on their communities broadly. Includes comparisons of community benefit and patient care services indicators provided by CAHs and other rural and urban hospitals.
Author(s): Zachariah Croll, John Gale
Date: 03/2024
Sponsoring organization: Flex Monitoring Team
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Partnerships to Address Social Needs Across Metropolitan and Non-Metropolitan Prospective Payment System Hospitals and Critical Access Hospitals
Explores the extent to which hospitals partner with community organizations to address population and/or community health needs. Analyzes data from the 2021 American Hospital Association Social Determinants of Health (SDOH) Supplement to describe the number and types of hospital partnerships with community-based organizations. Compares results by hospital type - metropolitan prospective payment system (PPS), Critical Access Hospital (CAH), and non-metropolitan PPS - and by U.S. Census region, ownership status, and accountable care organization (ACO) participation.
Author(s): Whitney E. Zahnd, Khyathi Gadag, Kristin D. Wilson, Keith J. Mueller
Date: 03/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores the extent to which hospitals partner with community organizations to address population and/or community health needs. Analyzes data from the 2021 American Hospital Association Social Determinants of Health (SDOH) Supplement to describe the number and types of hospital partnerships with community-based organizations. Compares results by hospital type - metropolitan prospective payment system (PPS), Critical Access Hospital (CAH), and non-metropolitan PPS - and by U.S. Census region, ownership status, and accountable care organization (ACO) participation.
Author(s): Whitney E. Zahnd, Khyathi Gadag, Kristin D. Wilson, Keith J. Mueller
Date: 03/2024
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Report to Congress on Medicaid and CHIP, March 2024
Reports on three aspects of Medicaid of interest to Congress: 1) improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs) and federal government actions to aid states, 2) increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Reports on three aspects of Medicaid of interest to Congress: 1) improving the Medicaid beneficiary experience through Medical Care Advisory Committees (MCACs) and federal government actions to aid states, 2) increasing the transparency and improving the monitoring of the denials and appeals process in Medicaid managed care, and 3) reviewing hospital payment policy for the nation's safety-net hospitals. Chapter 3 examines the relationship between disproportionate share hospital (DSH) allotments to states and the number of uninsured individuals, the amounts and sources of hospitals' uncompensated care costs, and the number of hospitals with high levels of uncompensated care that also provide essential community services. Table 3-1 details DSH spending for urban and rural hospitals and for Critical Access Hospitals.
Date: 03/2024
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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