Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others
Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Examines hospital margins for non-federal general short-term hospitals in the U.S. from 2018 through 2023, with a focus on operating margins. Analyzes RAND Hospital Data to explore the extent to which hospitals profited or lost money on patient care and other operating activities. Discusses differences in operating margins by hospital characteristics, including hospital ownership type, commercial share, size, rural or urban location, and Medicare rural payment designation.
Date: 12/2024
Sponsoring organization: KFF
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Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
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National Hospital Ambulatory Medical Care Survey: 2022 Emergency Department Summary Tables
Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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Provides data on ambulatory care emergency department (ED) hospital visits in 2022. Table 1 provides metropolitan/nonmetropolitan ED visit data based on hospital location.
Date: 11/2024
Sponsoring organization: National Center for Health Statistics
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The Potential for Hospital System Integration to Improve the Financial Outlook of Rural Hospitals in the United States
Provides an overview of the current financial status of rural hospitals and their risk of closure, as defined by days of cash on hand and total margins. Discusses the impact of rural hospital closures on local communities, including on health outcomes, demographics, and the economy. Explores the extent to which affiliating with, merging with, or being acquired by a larger hospital system can impact the financial position of rural hospitals.
Author(s): Al Dobson, Michael Beins, Patrick McMahon, et al.
Date: 11/2024
Sponsoring organizations: Coalition to Strengthen America's Healthcare, Dobson DaVanzo & Associates
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Provides an overview of the current financial status of rural hospitals and their risk of closure, as defined by days of cash on hand and total margins. Discusses the impact of rural hospital closures on local communities, including on health outcomes, demographics, and the economy. Explores the extent to which affiliating with, merging with, or being acquired by a larger hospital system can impact the financial position of rural hospitals.
Author(s): Al Dobson, Michael Beins, Patrick McMahon, et al.
Date: 11/2024
Sponsoring organizations: Coalition to Strengthen America's Healthcare, Dobson DaVanzo & Associates
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
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) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators
Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Sponsoring organization: University of Minnesota Rural Health Research Center
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Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Sponsoring organization: University of Minnesota Rural Health Research Center
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The Availability of Midwifery Care in Rural United States Communities
Describes the availability of midwifery care at rural hospitals in 2021. Presents results of a survey of 292 rural hospitals with current or recently closed childbirth services. Details whether rural hospitals with current or prior childbirth services had midwifery care with certified nurse-midwives available locally. Compares rural communities with and without midwifery care by hospital-level and county-level characteristics.
Author(s): Emily C. Sheffield, Alyssa H. Fritz, Julia D. Interrante, Katy B. Kozhimannil
Citation: Journal of Midwifery & Women's Health, 69(6), 929-936
Date: 11/2024
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Describes the availability of midwifery care at rural hospitals in 2021. Presents results of a survey of 292 rural hospitals with current or recently closed childbirth services. Details whether rural hospitals with current or prior childbirth services had midwifery care with certified nurse-midwives available locally. Compares rural communities with and without midwifery care by hospital-level and county-level characteristics.
Author(s): Emily C. Sheffield, Alyssa H. Fritz, Julia D. Interrante, Katy B. Kozhimannil
Citation: Journal of Midwifery & Women's Health, 69(6), 929-936
Date: 11/2024
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Medicare Claims Processing Manual Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS)
Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines rules and regulations for processing Medicare Part B hospital claims. Covers special rules for Critical Access Hospital outpatient billing, hospital-based Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) billing for non-RHC/FQHC services, and payment adjustments for Rural Emergency Hospitals (REHs).
Date: 11/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Hospital Price Transparency: What Hospitals Need to Know – Part 2
Webinar recording presents part two of a discussion on the Centers for Medicare and Medicaid Services (CMS) hospital price transparency requirements that went into effect on July 1, 2024. Features a presentation and discussion from a CMS representative.
Date: 10/2024
Sponsoring organization: Rural Health Information Hub
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Webinar recording presents part two of a discussion on the Centers for Medicare and Medicaid Services (CMS) hospital price transparency requirements that went into effect on July 1, 2024. Features a presentation and discussion from a CMS representative.
Date: 10/2024
Sponsoring organization: Rural Health Information Hub
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Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Sponsoring organization: Centers for Medicare and Medicaid Services
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Last Updated: 11/5/2025