Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
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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The Impact of High Hospital Fixed-Cost Ratios on Rural Populations
Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Explores how rurality relates to hospital cost structures as categorized by Urban Influence Codes (UICs). Describes the characteristics of hospitals at different fixed-to-total-cost ratio levels, the demographics associated with hospitals at different ratio levels, and the share of nonmetropolitan hospitals that have Critical Access Hospital (CAH) or Low-Volume Hospital (LVH) designations. Discusses how findings could be used to refine hospital payment policies.
Author(s): Abigail Barker, Eliot Jost, Timothy McBride, Keith Mueller
Date: 06/2025
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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MedPAC Comment on CMS's Proposed Rule on Inpatient Prospective Payment System for FY 2026
Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an April 30, 2025, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals to update inpatient prospective payment systems (IPPS) payment rates, update wage index values and policies, modify the Transforming Episode Accountability Model (TEAM), and remove the proposed health-equity adjustment from the Hospital Value-Based Purchasing (VBP) Program.
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Effects of Using Different Rural Measurements on Estimates of Hospitalizations for Depression and Substance Use
Explores how using different rural measurements can affect estimates of hospitalization rates for behavioral health conditions. Highlights how rural-urban commuting areas (RUCA) codes, core-based statistical areas (CBSA), urban-rural category four (URCategory4), and rural urban continuum codes (RUCC) affect hospitalization estimates. Discusses the consequences these difference can have on policy.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, et al.
Citation: BMC Health Services Research, 25, 818
Date: 06/2025
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Explores how using different rural measurements can affect estimates of hospitalization rates for behavioral health conditions. Highlights how rural-urban commuting areas (RUCA) codes, core-based statistical areas (CBSA), urban-rural category four (URCategory4), and rural urban continuum codes (RUCC) affect hospitalization estimates. Discusses the consequences these difference can have on policy.
Author(s): Robin Danek, Justin Blackburn, Marion Greene, et al.
Citation: BMC Health Services Research, 25, 818
Date: 06/2025
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Preventing Medical Debt among Rural Residents: Example Programs from Hospitals in Minnesota and Montana
Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Impact of Telemental Health on Suicide Prevention Care in U.S. Emergency Departments
Describes results of a survey of 977 hospital emergency departments regarding the use of telemental healthcare, and presents data by hospital characteristics, including rural location and Critical Access Hospital (CAH) status. Explores whether access to telemental healthcare affects use of six recommended suicide prevention practices. Compares the use of suicide prevention practices among patients with identified suicide risk by telemental healthcare status and CAH designation.
Author(s): Stephanie K. Doupnik, Cadence F. Bowden, Diana Worsley, et al.
Citation: Academic Emergency Medicine, 32(9), 956-965
Date: 05/2025
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Describes results of a survey of 977 hospital emergency departments regarding the use of telemental healthcare, and presents data by hospital characteristics, including rural location and Critical Access Hospital (CAH) status. Explores whether access to telemental healthcare affects use of six recommended suicide prevention practices. Compares the use of suicide prevention practices among patients with identified suicide risk by telemental healthcare status and CAH designation.
Author(s): Stephanie K. Doupnik, Cadence F. Bowden, Diana Worsley, et al.
Citation: Academic Emergency Medicine, 32(9), 956-965
Date: 05/2025
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Negotiated Prices for Care at Independent and System-Affiliated Rural Hospitals
Compares negotiated prices for procedural and imaging services at independent rural hospitals versus system-affiliated rural hospitals. Analyzes commercially negotiated price data with their associated hospital and evaluates number of negotiated prices for services. Discusses policies for rural hospital financial sustainability.
Author(s): Cody Lendon Mullens, Mitchell Mead, James D Lee, et al.
Citation: JAMA Network Open, 8(5)
Date: 05/2025
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Compares negotiated prices for procedural and imaging services at independent rural hospitals versus system-affiliated rural hospitals. Analyzes commercially negotiated price data with their associated hospital and evaluates number of negotiated prices for services. Discusses policies for rural hospital financial sustainability.
Author(s): Cody Lendon Mullens, Mitchell Mead, James D Lee, et al.
Citation: JAMA Network Open, 8(5)
Date: 05/2025
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Last Updated: 9/17/2025