Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Financial Challenges of Providing Obstetric Services at Rural Us Hospitals
Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Evaluation of the Rural Community Hospital Demonstration: CCA Extension Final Report (Covering 2016-2021)
Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Provides an overview of the Rural Community Hospital Demonstration (RCHD), focusing on the 26 hospitals that participated during the extension period authorized by the 21st Century Cures Act (2016-2021). Describes the characteristics of active RCHD participants before they joined the demonstration, the Medicare payments received under the program, and the impact of the RCHD on hospital financial measures.
Additional links: Appendices, At-A-Glance, Executive Summary
Date: 09/2025
Sponsoring organizations: American Institutes for Research, Centers for Medicare and Medicaid Services
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Hospital Trends in the Use, Evaluation, and Governance of Predictive AI, 2023-2024
Describes trends in the foundational use, evaluation, and governance of predictive artificial intelligence (AI) in hospitals using data from the 2023 and 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the differences in acute care hospitals' use of predictive AI by hospital size, CAH status, rural/urban location, independent/system affiliation, and electronic health record (EHR) vendor.
Date: 09/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Describes trends in the foundational use, evaluation, and governance of predictive artificial intelligence (AI) in hospitals using data from the 2023 and 2024 American Hospital Association (AHA) Information Technology (IT) supplement. Presents data on the differences in acute care hospitals' use of predictive AI by hospital size, CAH status, rural/urban location, independent/system affiliation, and electronic health record (EHR) vendor.
Date: 09/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Tax-Exempt Hospitals Provided Nearly $149 Billion in Total Benefits to Their Communities
Summarizes the benefits nonprofit hospitals provide their communities based on an analysis of IRS Form 990 Schedule H. Addresses the percent spent on financial assistance, health professions education, medical research, community building activities, and other categories included on Schedule H. Includes data for rural and Critical Access Hospitals.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Summarizes the benefits nonprofit hospitals provide their communities based on an analysis of IRS Form 990 Schedule H. Addresses the percent spent on financial assistance, health professions education, medical research, community building activities, and other categories included on Schedule H. Includes data for rural and Critical Access Hospitals.
Date: 09/2025
Sponsoring organization: American Hospital Association
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Sustaining Rural Labor & Delivery Programs: Strategies for Financial Analyses and Considerations for Maintaining Services
A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Growth of Health IT-Enabled Patient Engagement Capabilities Among U.S. Hospitals: 2021-2024
Describes hospital trends regarding the adoption of capabilities that enable patient access to their electronic health information, including the ability to view, download, transmit, and import data from other organizations into their patient portal; view clinical notes; and access information through apps between 2021-2024. Presents data and analysis by hospital type, including Critical Access Hospitals (CAHs) and rural hospitals, on the percent of hospitals that app-based and Fast Healthcare Interoperability Resource® (FHIR)-enabled patient engagement capabilities.
Author(s): Meghan Hufstader Gabriel, Chelsea Richwine, Priscilla Owusu-Mensah, Catherine Strawley
Date: 08/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Describes hospital trends regarding the adoption of capabilities that enable patient access to their electronic health information, including the ability to view, download, transmit, and import data from other organizations into their patient portal; view clinical notes; and access information through apps between 2021-2024. Presents data and analysis by hospital type, including Critical Access Hospitals (CAHs) and rural hospitals, on the percent of hospitals that app-based and Fast Healthcare Interoperability Resource® (FHIR)-enabled patient engagement capabilities.
Author(s): Meghan Hufstader Gabriel, Chelsea Richwine, Priscilla Owusu-Mensah, Catherine Strawley
Date: 08/2025
Sponsoring organization: Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology
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Trends in Hospital Administrative Costs: Urban–Rural Disparities, Barriers, and Reduction Strategies
Compares Medicare cost report data from 2011 and 2022 for over 4,400 rural and urban short-term acute care hospitals to identify shifts in administrative and general (A&G) spending. Discusses 3 themes related to cost growth, barriers in reporting, and strategies to manage and reduce costs. Describes implications for hospital policy.
Author(s): Lauree Handlon, Kit Simpson, Larry Leaming, Dunc Williams
Citation: Health Affairs Scholar, 3(8)
Date: 08/2025
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Compares Medicare cost report data from 2011 and 2022 for over 4,400 rural and urban short-term acute care hospitals to identify shifts in administrative and general (A&G) spending. Discusses 3 themes related to cost growth, barriers in reporting, and strategies to manage and reduce costs. Describes implications for hospital policy.
Author(s): Lauree Handlon, Kit Simpson, Larry Leaming, Dunc Williams
Citation: Health Affairs Scholar, 3(8)
Date: 08/2025
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The Impact of Rural Hospital Closures and Mergers on Health System Ecologies: A Scoping Review
Examines 46 studies on rural hospital closures and mergers between 2010 to 2023, with a focus on understanding health system impacts, finances, workforce, utilization, access to facilities and services, and community and economic well-being.
Author(s): Alison Coates, Janice Probst, Kanika Sarwal, Suhaib Riaz, Agnes Grudniewicz
Citation: Medical Care Research and Review, 82(5)
Date: 07/2025
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Examines 46 studies on rural hospital closures and mergers between 2010 to 2023, with a focus on understanding health system impacts, finances, workforce, utilization, access to facilities and services, and community and economic well-being.
Author(s): Alison Coates, Janice Probst, Kanika Sarwal, Suhaib Riaz, Agnes Grudniewicz
Citation: Medical Care Research and Review, 82(5)
Date: 07/2025
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AHEAD CMS-Designed Medicare FFS HGB Calculator Tool for Acute Care Hospitals Demonstration
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool, which aims to support fee-for-service acute care hospitals in understanding the HGB financial methodology for the AHEAD Model. Discusses how an AHEAD Medicare Fee-for-Service Hospital Global Budget is constructed.
Additional links: AHEAD Model CMS-Designed Medicare FFS Acute Care Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Acute Care Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) fiscal year 2026 hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) final rule. Includes information about the Medicare Promoting Interoperability Program and the discontinuation of the low-wage index hospital policy for FY 2026 and subsequent years.
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Last Updated: 10/21/2025