Rural Hospitals – Resources
Selected recent or important resources focusing on Rural Hospitals.
Rural Hospital Financial Distress: Relative Risk in 2025
Infographic with a state-level map showing the number and percent of rural hospitals in each state at highest relative financial distress risk in 2025. Features statistics showing states with multiple hospitals, one hospital, and no hospitals at highest risk. Includes information on states with highest percentage of rural hospitals at highest relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Julie Perry, Mark Holmes
Date: 11/2025
Sponsoring organizations: North Carolina Rural Health Research Program, The Cecil G. Sheps Center for Health Services Research
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Infographic with a state-level map showing the number and percent of rural hospitals in each state at highest relative financial distress risk in 2025. Features statistics showing states with multiple hospitals, one hospital, and no hospitals at highest risk. Includes information on states with highest percentage of rural hospitals at highest relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Julie Perry, Mark Holmes
Date: 11/2025
Sponsoring organizations: North Carolina Rural Health Research Program, The Cecil G. Sheps Center for Health Services Research
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Third Party Negotiated Hospital Pricing in Rural and Urban Hospitals within 12 U.S. States
Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Examines the gross and negotiated pricing for common services in rural and urban hospitals. Bases findings on samples from 12 states and focuses on costs of routine care, imaging, and childbirth.
Author(s): Lindsey R. Hammerslag, Aaron P. Smith, Jeffrey C. Talbert
Date: 11/2025
Sponsoring organization: Rural and Underserved Health Research Center
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Is My Hospital Rural?
An infographic that provides a U.S. map showing state-level rural hospital coverage versus total hospital coverage. Includes information on bed availability, access, and economic impact.
Date: 11/2025
Sponsoring organization: American Hospital Association
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An infographic that provides a U.S. map showing state-level rural hospital coverage versus total hospital coverage. Includes information on bed availability, access, and economic impact.
Date: 11/2025
Sponsoring organization: American Hospital Association
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Geriatric Emergency Department Accreditation for Rural Providers, with Kevin Biese and Natalie Elder
An episode of the Exploring Rural Health podcast featuring Kevin Biese, MD, Chair of the Board of the American College of Emergency Physicians Geriatric Emergency Accreditation program, and Natalie Elder, MD, Director of Geriatric Emergency Medicine for the University of Vermont Health Network. Focuses on the Geriatric Emergency Department Accreditation and the standards of rural geriatric care that it ensures.
Date: 11/2025
Sponsoring organization: Rural Health Information Hub
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An episode of the Exploring Rural Health podcast featuring Kevin Biese, MD, Chair of the Board of the American College of Emergency Physicians Geriatric Emergency Accreditation program, and Natalie Elder, MD, Director of Geriatric Emergency Medicine for the University of Vermont Health Network. Focuses on the Geriatric Emergency Department Accreditation and the standards of rural geriatric care that it ensures.
Date: 11/2025
Sponsoring organization: Rural Health Information Hub
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Medicare Payment Basics: Outpatient Hospital Services Payment System
Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Outlines Medicare's payments for outpatient hospital services, including considerations for rural sole community hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Overview of Medicare payments to hospitals for acute inpatient care. Includes information on rate setting, Medicare payments for medical education, payments to Medicare Disproportionate Share Hospitals (DSH), new technology payments special payments for rural hospitals, quality incentive payments and penalties, and payment rate updates.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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2010-2023 County-Level Hospital-Based Obstetric Care Status
County-level dataset containing the county Federal Information Processing Standard (FIPS) code, county, state, and indicator of whether each county had hospital-based obstetrics care in years 2010-2023. Available for download as an XLS file.
Author(s): Julia D. Interrante, Emily C. Sheffield, Kevan O'Hanlon, Katy Kozhimannil
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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County-level dataset containing the county Federal Information Processing Standard (FIPS) code, county, state, and indicator of whether each county had hospital-based obstetrics care in years 2010-2023. Available for download as an XLS file.
Author(s): Julia D. Interrante, Emily C. Sheffield, Kevan O'Hanlon, Katy Kozhimannil
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status, Version 2 with Addendum
Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units. Addendum describes methodology updates since a previously published January 2022 report as well as additional findings using 2010-2023 data.
Additional links: An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status (Version 1, 2022)
Author(s): Julia D. Interrante, Caitlin Carroll, Emily C. Sheffield, et al.
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units. Addendum describes methodology updates since a previously published January 2022 report as well as additional findings using 2010-2023 data.
Additional links: An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status (Version 1, 2022)
Author(s): Julia D. Interrante, Caitlin Carroll, Emily C. Sheffield, et al.
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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The Evolving Role of Critical Access Hospitals in Rural Physician Training
Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Financial Challenges of Providing Obstetric Services at Rural US Hospitals
Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Last Updated: 11/24/2025

