Rural Emergency Hospitals – Resources
Selected recent or important resources focusing on Rural Emergency Hospitals.
Rural Health Safety Net Under Renewed Pressure as Pandemic Fades
Examines financial and operational metrics for rural hospitals, comparing hospitals in states that did and did not expand Medicaid, as well as the discontinuation of obstetrics and chemotherapy services. Discusses how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities and explores seven characteristics that may have the greatest impact on a facility's consideration to convert to an REH.
Date: 02/2023
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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Examines financial and operational metrics for rural hospitals, comparing hospitals in states that did and did not expand Medicaid, as well as the discontinuation of obstetrics and chemotherapy services. Discusses how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities and explores seven characteristics that may have the greatest impact on a facility's consideration to convert to an REH.
Date: 02/2023
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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Guidance for Rural Emergency Hospital Provisions, Conversion Process and Conditions of Participation
Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program and State Operations Manual Appendix O - Survey Protocol, Regulations and Interpretive Guidelines for Rural Emergency Hospitals.
Date: 01/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program and State Operations Manual Appendix O - Survey Protocol, Regulations and Interpretive Guidelines for Rural Emergency Hospitals.
Date: 01/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Characteristics of Rural Hospitals Eligible for Conversion to Rural Emergency Hospitals and Three Rural Hospitals Considering Conversion
Findings brief presenting updated data for Rural Emergency Hospital (REH)-eligible hospitals. Compares financial and operational measures of 3 rural hospitals that have expressed interest in REH conversion with those of all 1,787 REH-eligible hospitals. Also discusses what factors may determine the number of rural hospitals that convert to REH, including risk of permanent closure.
Author(s): George Pink, Susie Gurzenda, Kristie Thompson, Ann Howard
Date: 12/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Findings brief presenting updated data for Rural Emergency Hospital (REH)-eligible hospitals. Compares financial and operational measures of 3 rural hospitals that have expressed interest in REH conversion with those of all 1,787 REH-eligible hospitals. Also discusses what factors may determine the number of rural hospitals that convert to REH, including risk of permanent closure.
Author(s): George Pink, Susie Gurzenda, Kristie Thompson, Ann Howard
Date: 12/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
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Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital
Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Small Rural Hospitals with Low-Volume Emergency Departments that May Convert to a Rural Emergency Hospital (REH)
Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Explores a variety of characteristics of Critical Access Hospitals (CAHs) and rural hospitals eligible to convert to the Rural Emergency Hospital (REH) designation, including patient volume, services and technology, EMS, and clinical staffing characteristics. Compares eligible hospitals by emergency department volume in 2019. Summarizes observations made by emergency department physician advisers regarding this data and REH implementation concerns.
Author(s): Margaret Greenwood-Ericksen, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Health Workforce Implications for the Rural Emergency Hospital Model
Describes workforce challenges hospitals converting to Rural Emergency Hospital status may experience. Discusses flexible staffing models, utilization of behavioral health providers, colocation of health and human services providers and team-based care, and recruitment and retention.
Author(s): Jacob Rains
Citation: Health Affairs Forefront
Date: 10/2022
Type: Document
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Describes workforce challenges hospitals converting to Rural Emergency Hospital status may experience. Discusses flexible staffing models, utilization of behavioral health providers, colocation of health and human services providers and team-based care, and recruitment and retention.
Author(s): Jacob Rains
Citation: Health Affairs Forefront
Date: 10/2022
Type: Document
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Next Steps for the Rural Emergency Hospital Model
Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Blog post discussing rural hospital closures and how the Rural Emergency Hospital (REH) model can help financially vulnerable hospitals align their services to the needs of the community. Highlights recommendations to the U.S. Department of Health and Human Services regarding REH Conditions of Participation and payment.
Date: 09/2022
Type: Document
Sponsoring organization: Bipartisan Policy Center
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Last Updated: 2/9/2024