Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
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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Rural Health Leadership, with Steve Simonin
An episode of the Exploring Rural Health podcast featuring Steve Simonin, President and CEO of Iowa Specialty Hospital and Clinics. Focuses on how healthcare systems can invest in their communities, strategies for ensuring long-term rural health sustainability, and the importance of maintaining communication with state and federal support systems.
Date: 03/2024
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring Steve Simonin, President and CEO of Iowa Specialty Hospital and Clinics. Focuses on how healthcare systems can invest in their communities, strategies for ensuring long-term rural health sustainability, and the importance of maintaining communication with state and federal support systems.
Date: 03/2024
Sponsoring organization: Rural Health Information Hub
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The Impact of Rural General Hospital Closures on Communities—A Systematic Review of the Literature
Presents a literature review of studies on the health and economic effects hospital closures have had on rural communities. Analyzes 21 studies completed in the previous 8 years and details the economic and healthcare access outcomes identified.
Author(s): Carol A. Mills, Valerie A. Yeager, Kathleen T. Unroe, et al.
Citation: Journal of Rural Health, 40(2), 238-248
Date: 03/2024
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Presents a literature review of studies on the health and economic effects hospital closures have had on rural communities. Analyzes 21 studies completed in the previous 8 years and details the economic and healthcare access outcomes identified.
Author(s): Carol A. Mills, Valerie A. Yeager, Kathleen T. Unroe, et al.
Citation: Journal of Rural Health, 40(2), 238-248
Date: 03/2024
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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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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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Early Impacts of the Pennsylvania Rural Health Model on Potentially Avoidable Utilization
Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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Assesses the impact of the Pennsylvania Rural Health Model (PARHM) on potentially avoidable utilization rates between 2016 and 2022 by comparing participating and non-participating hospitals. Discusses the potential impact of COVID-19 on results.
Author(s): Donald S. Bourne, Eric T. Roberts, Lindsay M. Sabik
Citation: Health Affairs Scholar, 2(2)
Date: 02/2024
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The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Podcast episode featuring a discussion with Chris Barber, president and CEO of St. Bernards Healthcare, which serves communities in Arkansas and Missouri. Describes how certain Medicare Advantage plan practices can create problems for rural hospitals, health systems, and patients.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Analysis: Hospitals and Health Systems Are Critical to Preserving Access to Care for Rural Communities
Provides information on how hospitals provide access to healthcare for rural communities, with a focus on hospital outpatient departments (HOPDs). Includes data related to rural physician practice acquisitions, rural outpatient visits to an HOPD, Medicaid eligibility, and more.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Provides information on how hospitals provide access to healthcare for rural communities, with a focus on hospital outpatient departments (HOPDs). Includes data related to rural physician practice acquisitions, rural outpatient visits to an HOPD, Medicaid eligibility, and more.
Date: 01/2024
Sponsoring organization: American Hospital Association
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Hospital Financing: Volume Limits and Reporting Could Help Manage Risks of Expanding FHA's Mortgage Insurance Program
Describes the Federal Housing Administration's (FHA) Hospital Mortgage Insurance Program, which insures loans for capital improvements at hospitals; loans insured through the program between 2000 and 2022. Explores characteristics of hospitals ineligible for the program that may impact their financing options. Examines the potential effects and risks of extending Hospital Mortgage Insurance Program eligibility to currently ineligible hospital types on program participation risks. Offers recommendations to Congress if it decides to expand program eligibility to hospitals that primarily provide non-acute care services.
Additional links: Full Report
Date: 01/2024
Sponsoring organization: Government Accountability Office
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Describes the Federal Housing Administration's (FHA) Hospital Mortgage Insurance Program, which insures loans for capital improvements at hospitals; loans insured through the program between 2000 and 2022. Explores characteristics of hospitals ineligible for the program that may impact their financing options. Examines the potential effects and risks of extending Hospital Mortgage Insurance Program eligibility to currently ineligible hospital types on program participation risks. Offers recommendations to Congress if it decides to expand program eligibility to hospitals that primarily provide non-acute care services.
Additional links: Full Report
Date: 01/2024
Sponsoring organization: Government Accountability Office
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Last Updated: 1/29/2026

