Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
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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Variation, Overlap, and Stability in Defining Safety Net Hospitals
Results of a study examining the extent to which safety net hospitals overlap, change over time, and represent similar types of healthcare facilities. Features statistics with breakdowns including rural location and Critical Access Hospital designation.
Author(s): Paula Chatterjee, Joshua M. Liao, Kano Amagai, et al.
Citation: JAMA Network Open, 8(7), e2523923
Date: 07/2025
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Results of a study examining the extent to which safety net hospitals overlap, change over time, and represent similar types of healthcare facilities. Features statistics with breakdowns including rural location and Critical Access Hospital designation.
Author(s): Paula Chatterjee, Joshua M. Liao, Kano Amagai, et al.
Citation: JAMA Network Open, 8(7), e2523923
Date: 07/2025
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Emergency Department Visits among Rural and Urban Older Adults: Disparities in Ambulatory and Emergency Care Sensitive Conditions
Compares emergency department (ED) utilization for ambulatory care sensitive conditions (ACSCs) and emergency care sensitive conditions (ECSCs) among rural and urban Medicare beneficiaries. Presents findings from a pooled cross-sectional analysis of 2016–2020 Medicare Current Beneficiary Survey data.
Author(s): Cameron J. Gettel, Courtney Kitchen, Craig Rothenberg, et al.
Citation: BMC Health Services Research, 25, 275
Date: 07/2025
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Compares emergency department (ED) utilization for ambulatory care sensitive conditions (ACSCs) and emergency care sensitive conditions (ECSCs) among rural and urban Medicare beneficiaries. Presents findings from a pooled cross-sectional analysis of 2016–2020 Medicare Current Beneficiary Survey data.
Author(s): Cameron J. Gettel, Courtney Kitchen, Craig Rothenberg, et al.
Citation: BMC Health Services Research, 25, 275
Date: 07/2025
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MedPAC Data Book: Health Care Spending and the Medicare Program, 2025
Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Provides an overview of Medicare spending and highlights data on Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care provided through the Medicare program, and other payer liability. Examines settings of care, including rural-specific provider sites, as they relate to spending, access to care, and profit margins. Compares rural and urban beneficiaries and providers throughout. Chart 6-2 addresses rural hospital closures and Rural Emergency Hospital conversions.
Date: 07/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Obstetric Care Access Declined in Rural and Urban Hospitals Across US States, 2010–22
Examines the number and proportion of hospitals located in rural and urban counties in each state that lost hospital-based obstetric services between 2010 and 2022. Describes the proportion of hospitals without obstetric services for any reason by 2022.
Author(s): Katy Backes Kozhimannil, Julia D. Interrante, Caitlin Carroll, et al.
Citation: Health Affairs, 44(7), 806-811
Date: 07/2025
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Examines the number and proportion of hospitals located in rural and urban counties in each state that lost hospital-based obstetric services between 2010 and 2022. Describes the proportion of hospitals without obstetric services for any reason by 2022.
Author(s): Katy Backes Kozhimannil, Julia D. Interrante, Caitlin Carroll, et al.
Citation: Health Affairs, 44(7), 806-811
Date: 07/2025
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Last Updated: 9/15/2025