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Rural Health Information Hub

Critical Access Hospitals (CAHs) – Resources

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

Supporting Critical Access Hospital Staff during COVID-19
Presents summaries of initiatives taken in three Critical Access Hospitals (CAHs) to support staff during the COVID-19 pandemic with regard to child care, stress and well-being, and work flexibility. Discusses similarities across these programs and offers considerations for CAHs interested in implementing similar initiatives.
Author(s): Madeleine Pick, Megan Lahr, Shehrose Charania, Ira Moscovice
Date: 06/2022
Sponsoring organization: Flex Monitoring Team
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Impact of Cost Report on CAH Decision Making
Webinar recording discussing cost-based reimbursement and the implications of the Medicare cost report for Critical Access Hospitals (CAHs). Describes opportunities for CAHs to maximize reimbursement using the cost report. Part of a series of webinars directed toward rural hospital CEOs and CFOs. Transcript available in video description.
Date: 04/2022
Sponsoring organizations: Oklahoma Office of Rural Health, Stroudwater Associates
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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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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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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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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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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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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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Outcome Measures for State Flex Program Financial and Operational Improvement Interventions
Discusses strategies for State Flex Programs (SFP) to monitor Critical Access Hospital (CAH) financial and operational improvement (FOI) interventions and the underlying theories of the activities. Provides recommendations for short- and intermediate-term outcome measures to assist SFPs in monitoring FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zach Croll
Date: 12/2021
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospitals' Initial Response to COVID-19 by System Affiliation
Summarizes results of a survey of Critical Access Hospital (CAH) executives in eight states regarding the initial response to COVID-19 through August 2020. Presents data by system-affiliated and independent CAH status. Discusses COVID-19 case volume, personal protective equipment (PPE) supply, and the perceived impact of system affiliation status on facilities' overall response to COVID-19.
Author(s): Ira Moscovice, Madeleine Pick, Megan Lahr
Date: 11/2021
Sponsoring organization: Flex Monitoring Team
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Last Updated: 5/5/2025