Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Review of Rural U.S. Economic and Health Care Trends
Reviews recent literature and publicly available data to explore important issues at the nexus of healthcare and local economic vibrancy, and explores the economic implications associated with COVID-19. Includes sections on rural hospitals, the rural healthcare workforce, emergency medical services, insurance, and telehealth. Features statistics with breakdowns by 6 levels of population density and county-level maps showing Health Professional Shortage Areas and rural counties without obstetrical services.
Author(s): Alison Davis
Date: 09/2022
Sponsoring organization: Center for Economic Analysis of Rural Health
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Reviews recent literature and publicly available data to explore important issues at the nexus of healthcare and local economic vibrancy, and explores the economic implications associated with COVID-19. Includes sections on rural hospitals, the rural healthcare workforce, emergency medical services, insurance, and telehealth. Features statistics with breakdowns by 6 levels of population density and county-level maps showing Health Professional Shortage Areas and rural counties without obstetrical services.
Author(s): Alison Davis
Date: 09/2022
Sponsoring organization: Center for Economic Analysis of Rural Health
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Rural Hospital Closures Threaten Access: Solutions to Preserve Care in Local Communities
Provides an overview of rural hospital closures between 2010-2021. Discusses rural demographics and outlines trends affecting rural hospital financial sustainability, including patient volume and health, reimbursement, staffing shortages, COVID-19, new models of care, and more.
Date: 09/2022
Sponsoring organization: American Hospital Association
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Provides an overview of rural hospital closures between 2010-2021. Discusses rural demographics and outlines trends affecting rural hospital financial sustainability, including patient volume and health, reimbursement, staffing shortages, COVID-19, new models of care, and more.
Date: 09/2022
Sponsoring organization: American Hospital Association
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Public Health Preparedness: COVID-19 Medical Surge Experiences and Related HHS Efforts
Discusses the medical surge challenges of eight hospitals in response to the COVID-19 pandemic and how healthcare coalitions have supported the hospitals' efforts. Identifies challenges related to staffing, supplies, space, and information, as well as challenges unique to rural hospitals. Describes Administration for Strategic Preparedness and Response (ASPR) programs and activities to support medical surge readiness.
Additional links: Full Report
Date: 08/2022
Sponsoring organization: Government Accountability Office
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Discusses the medical surge challenges of eight hospitals in response to the COVID-19 pandemic and how healthcare coalitions have supported the hospitals' efforts. Identifies challenges related to staffing, supplies, space, and information, as well as challenges unique to rural hospitals. Describes Administration for Strategic Preparedness and Response (ASPR) programs and activities to support medical surge readiness.
Additional links: Full Report
Date: 08/2022
Sponsoring organization: Government Accountability Office
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Environmental Scan on Consolidation Trends and Impacts in Health Care Markets
Summarizes results of an environmental scan and describes the landscape of healthcare market consolidation across the United States. Analyzes the evidence on consolidation trends and the impacts of these trends on price, quality, and access in healthcare provider and insurance markets. Includes information on the impacts of hospital consolidation on rural healthcare quality and patient access.
Date: 08/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Summarizes results of an environmental scan and describes the landscape of healthcare market consolidation across the United States. Analyzes the evidence on consolidation trends and the impacts of these trends on price, quality, and access in healthcare provider and insurance markets. Includes information on the impacts of hospital consolidation on rural healthcare quality and patient access.
Date: 08/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Corporation
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Staffing Hurdles Chip Away at Access to Care
Summarizes the results of a survey of rural hospital leaders between March 2-April 15, 2022. Explores how rural hospitals are navigating COVID-19 vaccination mandates and the continued impact of nurse staffing shortages on the delivery of care. Discusses drivers of nurse turnover at rural hospitals.
Author(s): Michael Topchik, Troy Brown, Melanie Pinette, Billy Balfour
Date: 08/2022
Sponsoring organization: Chartis Center for Rural Health
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Summarizes the results of a survey of rural hospital leaders between March 2-April 15, 2022. Explores how rural hospitals are navigating COVID-19 vaccination mandates and the continued impact of nurse staffing shortages on the delivery of care. Discusses drivers of nurse turnover at rural hospitals.
Author(s): Michael Topchik, Troy Brown, Melanie Pinette, Billy Balfour
Date: 08/2022
Sponsoring organization: Chartis Center for Rural Health
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Engaging Your Board and Community in Value-Based Care Conversations
Provides starting points for healthcare organizations to engage in value-based care conversations with their board and community members to support strategic planning and informed decision-making.
Date: 07/2022
Sponsoring organization: Rural Health Value
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Provides starting points for healthcare organizations to engage in value-based care conversations with their board and community members to support strategic planning and informed decision-making.
Date: 07/2022
Sponsoring organization: Rural Health Value
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Understanding CMS' Changes to Hospital Overall Star Ratings
Summarizes an analysis of the effects of methodological changes to the Centers for Medicare & Medicaid Services (CMS) star ratings system. Compares hospital star ratings in 2020 and 2021 and examines differences in ratings by hospital characteristics. Explores the equitability of the ratings by peer groups. Highlights challenges to comparing the ratings of small hospitals and Critical Access Hospitals. Provides recommendations for CMS to improve the equity of the star ratings.
Date: 07/2022
Sponsoring organization: American Hospital Association
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Summarizes an analysis of the effects of methodological changes to the Centers for Medicare & Medicaid Services (CMS) star ratings system. Compares hospital star ratings in 2020 and 2021 and examines differences in ratings by hospital characteristics. Explores the equitability of the ratings by peer groups. Highlights challenges to comparing the ratings of small hospitals and Critical Access Hospitals. Provides recommendations for CMS to improve the equity of the star ratings.
Date: 07/2022
Sponsoring organization: American Hospital Association
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County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care
Policy brief providing data on the economic changes in counties that lost obstetric care facilities between 2012-2019. Describes demographic and economic differences between counties with or without obstetric care facilities. Features statistics with breakdowns by urban or rural location and a county-level map with shadings showing availability of obstetric services and hospital closures from 2012-2019.
Author(s): Andrew L. Owen, Alison Davis, Simona Balazs
Date: 07/2022
Sponsoring organization: Center for Economic Analysis of Rural Health
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Policy brief providing data on the economic changes in counties that lost obstetric care facilities between 2012-2019. Describes demographic and economic differences between counties with or without obstetric care facilities. Features statistics with breakdowns by urban or rural location and a county-level map with shadings showing availability of obstetric services and hospital closures from 2012-2019.
Author(s): Andrew L. Owen, Alison Davis, Simona Balazs
Date: 07/2022
Sponsoring organization: Center for Economic Analysis of Rural Health
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Risk of Closure Among Independent and Multihospital-Affiliated Rural Hospitals
Study examining the risk of rural hospital closure for independent hospitals and hospitals affiliated with other facilities or a health system. Analyzes 2007-2019 data from the American Hospital Association, Irving Levin Associates, and the University of North Carolina Sheps Center representing a national cohort of rural hospitals. Notes financial stability for affiliated and independent hospitals as well as policy interventions to support hospitals at risk of closure.
Author(s): H. Joanna Jiang, Kathryn R. Fingar, Lan Liang, Rachel Mosher Henke
Citation: JAMA Health Forum, 3(7), e221835
Date: 07/2022
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Study examining the risk of rural hospital closure for independent hospitals and hospitals affiliated with other facilities or a health system. Analyzes 2007-2019 data from the American Hospital Association, Irving Levin Associates, and the University of North Carolina Sheps Center representing a national cohort of rural hospitals. Notes financial stability for affiliated and independent hospitals as well as policy interventions to support hospitals at risk of closure.
Author(s): H. Joanna Jiang, Kathryn R. Fingar, Lan Liang, Rachel Mosher Henke
Citation: JAMA Health Forum, 3(7), e221835
Date: 07/2022
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The Economic Effects of Rural Hospital Closures
Examines the impact of a rural hospital closure on local economic outcomes. Compares economic changes in nonmetro counties experiencing a hospital closure between 2001 and 2018 to changes in a control group of nonmetro counties. Presents data on the effects of rural hospital closures on annual income, population size, unemployment, and labor force size overall and by closure type and Critical Access Hospital (CAH) and Prospective Payment System (PPS) status.
Author(s): Tyler L. Malone, Arrianna Marie Planey, Laura B. Bozovich, Kristie W. Thompson, George M. Holmes
Citation: Health Services Research, 57(3), 614-623
Date: 06/2022
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Examines the impact of a rural hospital closure on local economic outcomes. Compares economic changes in nonmetro counties experiencing a hospital closure between 2001 and 2018 to changes in a control group of nonmetro counties. Presents data on the effects of rural hospital closures on annual income, population size, unemployment, and labor force size overall and by closure type and Critical Access Hospital (CAH) and Prospective Payment System (PPS) status.
Author(s): Tyler L. Malone, Arrianna Marie Planey, Laura B. Bozovich, Kristie W. Thompson, George M. Holmes
Citation: Health Services Research, 57(3), 614-623
Date: 06/2022
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Last Updated: 8/29/2025