Previous work by the RUPRI Center showed significant
growth in hospital system membership among
non-metropolitan hospitals from 2007 to 2012.
Re-examining data from the American Hospital Association
through 2016 shows continued growth in system membership
among all categories of hospital size, location, and
Critical Access Hospital (CAH) status. However, the
growth rate in system membership declined in metropolitan
hospitals in the South census region and non-metropolitan
CAHs in all census regions. Our analysis also indicates
that non-metropolitan CAHs and hospitals make up a small
portion of hospitals in the largest healthcare systems.
Non-metropolitan hospitals and non-metropolitan CAHs face
unique challenges given the demographics of the
population they serve, payer mix, and reimbursement