Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Medicare Advantage Penetration and the Financial Distress of Rural Hospitals
Examines county-level Medicare Advantage (MA) penetration rates and the financial impact on rural hospitals. Utilizes 2014-2020 American Hospital Association data to analyze Medicare and non-Medicare inpatient days paid by the plans, with data breakdowns according to patient demographics, rural versus urban location, timing of inpatient stay, and more.
Author(s): Guido Cataife, Siying Liu
Citation: Health Economics Review, 15, 9
Date: 02/2025
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Examines county-level Medicare Advantage (MA) penetration rates and the financial impact on rural hospitals. Utilizes 2014-2020 American Hospital Association data to analyze Medicare and non-Medicare inpatient days paid by the plans, with data breakdowns according to patient demographics, rural versus urban location, timing of inpatient stay, and more.
Author(s): Guido Cataife, Siying Liu
Citation: Health Economics Review, 15, 9
Date: 02/2025
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Chartis Center for Rural Health Research & Resources for the 2025 National Rural Health Association's Rural Health Policy Institute Conference
Offers research and analysis of the stability of the rural healthcare safety net. Includes Instability Continues to Threaten Rural Health Safety Net: Reduced Reimbursements, Dwindling Access to Care, and Deteriorating Population Health Status, and presentation slides on this report from the 2025 National Rural Health Association Policy Institute. Provides links to national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Offers research and analysis of the stability of the rural healthcare safety net. Includes Instability Continues to Threaten Rural Health Safety Net: Reduced Reimbursements, Dwindling Access to Care, and Deteriorating Population Health Status, and presentation slides on this report from the 2025 National Rural Health Association Policy Institute. Provides links to national and state data tables showing the financial impact of federal policies on rural hospitals.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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2025 Stability of the Rural Health Safety Net: State and National Data Tables
Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2025 National Rural Health Association Policy Institute.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Provides links to national and state data tables showing the financial impact of federal policies such as sequestration and bad debt reimbursement on rural hospital revenues, jobs, and gross domestic product. Presented at the February 2025 National Rural Health Association Policy Institute.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Instability Continues to Threaten Rural Health Safety Net: Reduced Reimbursements, Dwindling Access to Care and Deteriorating Population Health Status
Examines factors contributing to the instability of the rural healthcare safety net, including policy-related reimbursement cuts and changes to payer mixes. Presents data on rural hospitals that have stopped offering obstetrics and chemotherapy services. Explores aspects of rural population health and social drivers of health as they relate to rural healthcare delivery challenges.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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Examines factors contributing to the instability of the rural healthcare safety net, including policy-related reimbursement cuts and changes to payer mixes. Presents data on rural hospitals that have stopped offering obstetrics and chemotherapy services. Explores aspects of rural population health and social drivers of health as they relate to rural healthcare delivery challenges.
Date: 02/2025
Sponsoring organization: Chartis Center for Rural Health
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National Academy for State Health Policy (NASHP) Hospital Cost Tool
Interactive tool providing information on how much hospitals spend on patient care services, how costs relate to the hospital charges, and actual prices paid by health plans. Presents data on a range of measures for hospital revenue, costs, profitability, and break-even points for over 5,000 hospitals nationwide between 2011 and 2023. Includes the ability to view and compare hospital financial metrics at the hospital, state, and health system levels.
Additional links: Hospital Cost Tool and Resources
Date: 02/2025
Sponsoring organization: National Academy for State Health Policy
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Interactive tool providing information on how much hospitals spend on patient care services, how costs relate to the hospital charges, and actual prices paid by health plans. Presents data on a range of measures for hospital revenue, costs, profitability, and break-even points for over 5,000 hospitals nationwide between 2011 and 2023. Includes the ability to view and compare hospital financial metrics at the hospital, state, and health system levels.
Additional links: Hospital Cost Tool and Resources
Date: 02/2025
Sponsoring organization: National Academy for State Health Policy
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Improving Rural Healthcare by Creating Academic- and Nonacademic-Rural Hospital Partnerships Based on Community Health Needs Assessments and Technological Needs
Explores the effect of creating partnerships between rural and urban healthcare systems to bolster economic and technological resiliency in struggling rural hospitals. Highlights the way partnerships with academic and nonacademic urban hospitals can help rural hospitals facilitate workforce recruitment and retention, access specialty care, and improve technological access, among other factors.
Author(s): Suhas Babu, James N. Weinstein, Juan M. Lavista Ferres, William B. Weeks
Citation: Journal of Rural Health, 41(1), e12927
Date: 01/2025
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Explores the effect of creating partnerships between rural and urban healthcare systems to bolster economic and technological resiliency in struggling rural hospitals. Highlights the way partnerships with academic and nonacademic urban hospitals can help rural hospitals facilitate workforce recruitment and retention, access specialty care, and improve technological access, among other factors.
Author(s): Suhas Babu, James N. Weinstein, Juan M. Lavista Ferres, William B. Weeks
Citation: Journal of Rural Health, 41(1), e12927
Date: 01/2025
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Rural Nonprofit Hospital Community Benefit and Financial Assistance Spending: A Call for Greater Reporting Transparency
Examines the variation in community benefit and financial assistance spending among rural nonprofit hospitals that filed group returns in Wisconsin and Minnesota. Analyzes 2021 nonprofit hospital tax data to explore whether group filers' community benefit spending differed from individual nonprofit hospital filers. Discusses potential implications of policy recommendations that would require nonprofit hospitals to file individual tax returns.
Author(s): Hannah MacDougall, Melissa Latcham, Erica Eliason
Citation: Journal of Rural Health, 41, e12914
Date: 01/2025
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Examines the variation in community benefit and financial assistance spending among rural nonprofit hospitals that filed group returns in Wisconsin and Minnesota. Analyzes 2021 nonprofit hospital tax data to explore whether group filers' community benefit spending differed from individual nonprofit hospital filers. Discusses potential implications of policy recommendations that would require nonprofit hospitals to file individual tax returns.
Author(s): Hannah MacDougall, Melissa Latcham, Erica Eliason
Citation: Journal of Rural Health, 41, e12914
Date: 01/2025
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U.S. Hospital List (2024)
Excel file providing a comprehensive list of urban and rural U.S. hospitals that were reported open as of January 1, 2024. Includes 4,497 acute care hospitals and 1,457 specialty hospitals.
Date: 2025
Sponsoring organization: North Carolina Rural Health Research Program
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Excel file providing a comprehensive list of urban and rural U.S. hospitals that were reported open as of January 1, 2024. Includes 4,497 acute care hospitals and 1,457 specialty hospitals.
Date: 2025
Sponsoring organization: North Carolina Rural Health Research Program
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An Updated Model of Rural Hospital Financial Distress
Discusses a potential model to predict financial distress in rural hospitals, including negative cash flow margin, negative equity, or closure of facility. Tests 2,311 rural hospitals from 2013 to 2019 with the model and discusses its potential to predict financial distress and create accurate assessments.
Author(s): Tyler L. Malone, George H. Pink, George M. Holmes
Citation: Journal of Rural Health, 41(2)
Date: 2025
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Discusses a potential model to predict financial distress in rural hospitals, including negative cash flow margin, negative equity, or closure of facility. Tests 2,311 rural hospitals from 2013 to 2019 with the model and discusses its potential to predict financial distress and create accurate assessments.
Author(s): Tyler L. Malone, George H. Pink, George M. Holmes
Citation: Journal of Rural Health, 41(2)
Date: 2025
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The Pennsylvania Rural Health Model (PARHM): Fourth Annual Evaluation Report
Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Evaluates the fourth performance year of the Pennsylvania Rural Health Model (PARHM), an initiative designed to test if global budgets can help rural hospitals improve their financial viability, provide flexibility to meet locally defined community health needs, and reduce overall healthcare spending. Provides an overview of the model and describes the implementation experience of participating hospitals and payers. Presents a descriptive quantitative assessment of financial performance, spending and utilization, access to care, and quality of care outcomes from 2016, the model's baseline, through 2022. Includes three case studies discussing three themes: experiences with global budget reconciliation, behavioral health transformation, and interactions and alignment between PARHM and other value-based care programs.
Additional links: Appendix, Findings at a Glance
Date: 12/2024
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Last Updated: 10/24/2025