Rural Health
Research Gateway

RHCs and CAHs Participating in SSP: Characteristics of the Providers and Communities

Research center:
RUPRI Center for Rural Health Policy Analysis
Phone: 319.384.3832
Lead researcher:
Keith J. Mueller, PhD, 319.384.3832, keith-mueller@uiowa.edu
Research staff:
Fred Ullrich, BA
Project funded:
September 2023
Project completed:
November 2025
Topics:
Critical Access Hospitals (CAHs), Healthcare financing, Medicare, Rural Health Clinics (RHCs)

This project described characteristics of Rural Health Clinics (RHCs) and Critical Access Hospitals (CAHs) participating in the Medicare Shared Savings Program (SSP), and the communities they serve. Comparisons were made to RHCs and CAHs not participating in the SSP.

Descriptive analysis was used to characterize RHCs and CAHs based on size (number of providers in RHCs, patient days in CAHs), system affiliation by CAHs, for RHCs whether they are independent or provider-based, population of county served, number of Medicaid beneficiaries in the county, and penetration of Medicare Advantage in the county. We also adjusted the count of participating RHCs by attributing multiple RHCs to single provider entitles (including CAHs) as, in effect, one RHC (e.g., there are six RHCs owned by a CAH in Illinois that participates in Accountable Care Organizations – per a session at recent state meeting). Characteristics measured as means and medians for all participating clinics and hospitals were compared to characteristics of those not participating. A policy brief described the characteristics of CAHs and RHCs participating in the SSP, including the suggested adjustment to how we “count” the number of participating RHCs. A research paper expanded the analysis to include more analysis of the markets of participating CAHs and RHCs, and implications for reaching the CMS goal of 100 percent of beneficiaries served by providers participating in a value-based payment arrangement.


Publications