Developing a Financial Performance Measurement System for Critical Access Hospitals

Lead researcher:
Project funded:
September 2003
Project completed:
August 2008
This multi-year project uses research and expert opinion to select dimensions and indicators of financial performance, develop appropriate methods of peer comparison, and identify characteristics of high performing Critical Access Hospitals (CAHs). In year three of this project (2005-06) a Financial Indicators Report was be produced that included indicator definitions and interpretations, CAH-specific indicator values, median values for CAHs, and comparative data for 4 peer groups (with and without long-term care, with and without rural-based provider health clinic, government and non-government owned, and greater than and less than $10 million in total revenues). This CAH Financial Indicators Report was disseminated through a web-based tool maintained by the University of North Carolina, where CAH administrators are able to access and download their report directly from the website. During the current project year an updated CAH Financial Indicators Report will be produced that includes benchmarks for five indicators, and statistical analyses will be conducted to determine appropriate methods of combining the 20 financial indicators into an overall measure of financial performance.


  • Comparative Performance Data for Critical Access Hospitals
    Journal Article
    Maine Rural Health Research Center, North Carolina Rural Health Research and Policy Analysis Center
    Date: 2004
    Discusses the potential use of comparative performance data for critical access hospitals (CPD-CAH) to facilitate performance and quality improvement. Covers potential benefits and drawbacks of CPD-CH and identifies issues in the development and implementation of CPD-CAH.
  • Financial Indicators for Critical Access Hospitals
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 05/2005
    The purpose of this study was to develop and disseminate comparative financial indicators specifically for critical access hospitals using Medicare Cost Report data.
  • Variations in Financial Performance Among Peer Groups of Critical Access Hospitals
    Journal Article
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 2007
    Reports findings from a study that investigated whether indicators of financial performance and condition systematically vary among peer groups of Critical Access Hospitals (CAHs).