Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
A Comparison of Independent and System-Affiliated Rural Hospitals
Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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Compares independent and system-affiliated rural hospitals by organizational characteristics, financial performance, and county characteristics. Presents Medicare Cost Report data from 2023-2024 on the number and percentage of independent and system-affiliated rural hospitals by state, ownership characteristics, Medicare payment classification, use of swing beds, financial distress, and more.
Author(s): Aditya R. Pillutla, Sruthi Malavika Srinivasan, Kristie Thompson, George Pink, Tyler Malone
Date: 02/2026
Sponsoring organization: North Carolina Rural Health Research Program
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2026 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 2026 National Rural Health Association Policy Institute.
Date: 02/2026
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 2026 National Rural Health Association Policy Institute.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Chartis Center for Rural Health Research & Resources for the 2026 National Rural Health Association's Rural Health Policy Institute Conference
Offers research and analysis of the stability of the rural healthcare safety net. Includes 2026 Rural State of the State, and presentation slides on this report from the 2026 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: 02/2026
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 2026 Rural State of the State, and presentation slides on this report from the 2026 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: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Rural Healthcare Challenges Deepen as the Rural Health Transformation Program Ramps Up
Examines the impact of the Rural Health Transformation (RHT) program and the ongoing issues of rural hospital closures and financial losses, Medicaid policy, workforce shortages, diminishing access to rural healthcare services, and more. Discusses themes in state RHT applications and how they plan to utilize RHT funding.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Examines the impact of the Rural Health Transformation (RHT) program and the ongoing issues of rural hospital closures and financial losses, Medicaid policy, workforce shortages, diminishing access to rural healthcare services, and more. Discusses themes in state RHT applications and how they plan to utilize RHT funding.
Date: 02/2026
Sponsoring organization: Chartis Center for Rural Health
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Financial Assistance Policy, Hospital Charity Care, and Medical Debt in Collections
Explores whether Oregon's state-level financial assistance policy (FAP) was associated with a lower percentage of the population with medical debt in collections, increase in hospital charity care, and decrease in bad debt in the first 3 years after implementation. Compares county- and hospital-level data from Oregon with data from a sample of hospitals that expanded Medicaid in 2014 but had not implemented a state-level FAP by 2022. Supplemental content includes data by metropolitan and non-metropolitan status.
Author(s): Tatiane Santos, Richard C. Lindrooth, Gary J. Young, Shoou-Yih Lee
Citation: JAMA Network Open, 9(1), e2555698
Date: 01/2026
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Explores whether Oregon's state-level financial assistance policy (FAP) was associated with a lower percentage of the population with medical debt in collections, increase in hospital charity care, and decrease in bad debt in the first 3 years after implementation. Compares county- and hospital-level data from Oregon with data from a sample of hospitals that expanded Medicaid in 2014 but had not implemented a state-level FAP by 2022. Supplemental content includes data by metropolitan and non-metropolitan status.
Author(s): Tatiane Santos, Richard C. Lindrooth, Gary J. Young, Shoou-Yih Lee
Citation: JAMA Network Open, 9(1), e2555698
Date: 01/2026
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Rural Hospital Bypass by Patients With Commercial Health Insurance
Results of a study examining rural hospital bypass rates among commercially insured patients, and hospital payments from patients who bypassed their nearest hospitals. Features statistics with breakdowns by clinical category and 4 levels of population density.
Author(s): Jessica Y. Chang, Caitlin E. Carroll
Citation: JAMA Network Open, 9(1), e2555017
Date: 01/2026
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Results of a study examining rural hospital bypass rates among commercially insured patients, and hospital payments from patients who bypassed their nearest hospitals. Features statistics with breakdowns by clinical category and 4 levels of population density.
Author(s): Jessica Y. Chang, Caitlin E. Carroll
Citation: JAMA Network Open, 9(1), e2555017
Date: 01/2026
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Availability of Hospital-Based Obstetric Services in the United States by County, 2010–2023: A State-by-State Report
Provides national, state, and county-specific information on changes in obstetric care access from 2010-2023. Displays county-level maps of changes in hospital-based services availability between 2010-2023, highlighting changes from 2022 to 2023. Features statistics with breakdowns by urban and rural counties.
Author(s): Julia D. Interrante, Kevan O'Hanlon, Katy B. Kozhimannil
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
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Provides national, state, and county-specific information on changes in obstetric care access from 2010-2023. Displays county-level maps of changes in hospital-based services availability between 2010-2023, highlighting changes from 2022 to 2023. Features statistics with breakdowns by urban and rural counties.
Author(s): Julia D. Interrante, Kevan O'Hanlon, Katy B. Kozhimannil
Date: 01/2026
Sponsoring organization: University of Minnesota Rural Health Research Center
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U.S. Hospital List (2025)
Excel file providing a comprehensive list of urban and rural U.S. hospitals that were reported open as of January 1, 2025. Includes 4,541 acute care hospitals and 1,472 specialty hospitals.
Date: 2026
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, 2025. Includes 4,541 acute care hospitals and 1,472 specialty hospitals.
Date: 2026
Sponsoring organization: North Carolina Rural Health Research Program
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Changes in Bed-Based Measures of Surge Capacity from 2018 to 2022 among Rural and Urban Hospitals
Policy brief describing how hospitals' inpatient capacity changed from 2018-2022 and examining trade-offs between cost-saving reductions and emergency preparedness. Features statistics on hospitals' average daily census (ADC) and number and percentage of unoccupied beds, with breakdowns by year and urban or rural location.
Author(s): Emma Kerr, Tyler Malone, Mark Holmes
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Policy brief describing how hospitals' inpatient capacity changed from 2018-2022 and examining trade-offs between cost-saving reductions and emergency preparedness. Features statistics on hospitals' average daily census (ADC) and number and percentage of unoccupied beds, with breakdowns by year and urban or rural location.
Author(s): Emma Kerr, Tyler Malone, Mark Holmes
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Do Changes in Hospital Ownership Affect Staffing?
Findings brief examining whether transition from government or nonprofit to for-profit hospital ownership is associated with changes in staffing levels in rural hospitals. Utilizes 2011-2023 CMS Healthcare Cost Reporting Information System (HCRIS) data.
Author(s): Ayush Manandhar
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief examining whether transition from government or nonprofit to for-profit hospital ownership is associated with changes in staffing levels in rural hospitals. Utilizes 2011-2023 CMS Healthcare Cost Reporting Information System (HCRIS) data.
Author(s): Ayush Manandhar
Date: 12/2025
Sponsoring organization: North Carolina Rural Health Research Program
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Last Updated: 2/18/2026