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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Rural Hospital Stabilization Program Introduction
A recorded webinar that provides an overview on the Rural Hospital Stabilization Program. Focuses on the program's purpose and services as well as participation eligibility and the application/selection process. Transcript available below description.
Date: 02/2025
Sponsoring organization: National Rural Health Resource Center
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A recorded webinar that provides an overview on the Rural Hospital Stabilization Program. Focuses on the program's purpose and services as well as participation eligibility and the application/selection process. Transcript available below description.
Date: 02/2025
Sponsoring organization: National Rural Health Resource Center
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February 2025 MACPAC Meeting Transcript
Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Transcript from the Medicaid and CHIP Payment and Access Commission's (MACPAC) February 2025 meeting. Covers transitions of care for children and youth with special healthcare needs (CYSHCN), hospital non-disproportionate share hospital supplemental payments and directed payment targeting, improving access to medications for opioid use disorder, healthcare access for children in foster care, and more. Includes rural references throughout.
Additional links: Hospital Non-DSH Supplemental Payment and Directed Payment Targeting Analyses
Date: 02/2025
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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146 Rural Hospitals Closed or Stopped Providing Inpatient Services from 2005 to 2023 in the United States
Line chart showing the number of rural hospital closures and rural inpatient unit closures between 2005 and 2023.
Author(s): Anil Rupasingha, Julie Cho
Date: 02/2025
Sponsoring organization: USDA Economic Research Service
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Line chart showing the number of rural hospital closures and rural inpatient unit closures between 2005 and 2023.
Author(s): Anil Rupasingha, Julie Cho
Date: 02/2025
Sponsoring organization: USDA Economic Research Service
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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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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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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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Last Updated: 3/4/2026