Healthcare financing

Research Products

Alphabetical list. You can also view by publication date.

  • 2012-14 Profitability of Urban and Rural Hospitals by Medicare Payment Classification
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    The profitability of urban hospitals to that of rural hospitals are compared for fiscal years 2012-2014 based on size and rural Medicare payment classifications.
  • 2019 Wage Index Differences and Selected Characteristics of Rural and Urban Hospitals
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 05/2019
    This brief characterizes rural/urban disparities in the 2019 Centers for Medicare & Medicaid Services hospital wage index by describing and comparing the wage indices of rural and urban hospitals by the number of beds, the amount of net patient revenue, and Medicare payment classification.
  • Access to Rural Home Health Services: Views from the Field
    Report
    WWAMI Rural Health Research Center
    Date: 02/2016
    Access to home health care can be challenging for rural Medicare clients. Key informants for this study detailed obstacles, including financial, regulatory, workforce, and geographic issues. Rural communities will likely benefit from payment reforms that reward quality services while providing incentives to use best practices in home health care.
  • Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 10/2017
    Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries' use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services.
  • An Analysis of the Agreement of Financial Data between the Medicare Cost Report and the Audited Hospital Financial Statement
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2004
    Few studies have examined the discrepancies between the Medicare Cost Report (MCR) and the audited hospital financial statement (FS). Findings from this study, which focused on the MCR and FS for rural hospitals, suggest that relying on a single source of financial data to assess the financial performance of rural hospitals may be inappropriate.
  • Area Wage Index of the Medicare Inpatient Hospital Prospective Payment System: Perspectives, Policies, and Choices
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2000
    This policy paper summarizes the positions of various rural health advocates and records the actions taken by Congress and the Health Care Financing Administration to improve the wage index. Finally, it outlines the research needed to energize the policy discussion of the uses and methods of calculating the hospital wage index.
  • Assessing the Financial Effect of Medicare Payment on Rural Hospitals: Does the Source of Data Change the Results?
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2005
    This policy brief explores how predictions of changes in hospital financial performance differ when comparing results using data from the Medicare Cost Report (MCR) to data from the audited hospital financial statement (FS). Results indicate that using the MCR rather than FS data is more valid.
  • Assessing the Impact of Rural Provider Service Mix on the Primary Care Incentive Payment Program
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2013
    Under the Primary Care Incentive Payment Program (PCIP), if certain evaluation and management services represented 60% or more of Medicare allowable charges, the provider qualified for a 10% bonus calculated on the primary care portion of allowable charges. This brief assesses the impact of the rural provider service mix on the PCIP.
  • Average Beneficiary CMS Hierarchical Condition Category (HCC) Risk Scores for Rural and Urban Providers
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2018
    This brief investigates potential differences in urban and rural Centers for Medicare & Medicaid Services (CMS) hierarchical condition category (HCC) risk scores at the provider's patient panel level.
  • Background on the Wage-related Portion of the Medicare DRG Payments
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 09/2000
    This report discusses how to calculate Medicare diagnostic related group (DRG) payments. It includes examples and a diagram of how to calculate a DRG payment.
  • Care Coordination in Rural Communities Supporting the High Performance Rural Health System
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 06/2015
    This paper examines care coordination programs and processes that affect rural areas to discover what is happening in rural communities, how various programs and approaches are working, who benefits, and to make policy recommendations that will facilitate care coordination efforts in support of high performance rural health system development.
  • A Case Study of Rural Health Care in the Economic Downturn
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2009
    This report describes the economic and healthcare environment in Ashe County, a rural community in the mountains of western North Carolina. The experience in Ashe County exemplifies the healthcare challenges faced in many rural areas across the country.
  • Changes to the Merit-based Incentive Payment System Pertinent to Small and Rural Practices, 2018
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2018
    This policy brief highlights key regulatory changes to the Merit-based Incentive Payment System that occurred in 2018. It discusses the implications of these changes with an emphasis on how these changes may affect small and rural practices.
  • Characteristics of Communities Served by Rural Hospitals Predicted to be at High Risk of Financial Distress in 2019
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief compares characteristics of communities served by rural hospitals predicted to be at high risk of financial distress to those served by rural hospitals predicted to not be at high risk of financial distress in 2019.
  • Data Sources for Studying Uncompensated Care Provided by Rural Hospitals
    NORC Walsh Center for Rural Health Analysis
    Date: 08/2000
    This policy analysis brief discusses data sources related to hospitals' provision of charity and uncompensated care.
  • Developmental Strategies and Challenges for Rural Accountable Care Organizations
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 02/2015
    This brief offers insights into the initial strategic decisions and challenges of four accountable care organizations (ACOs) with rural presences. These ACOs were formed as a step toward a value-driven rural delivery system. While several challenges need to be addressed, these insights can inform development of other rural ACOs.
  • Distribution of Disproportionate Share Hospital Payments to Rural and Critical Access Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2017
    This policy brief provides information about the potential impact of scheduled changes in Medicaid Disproportionate Share Hospital (DSH) payment on hospitals in 47 states. We expect variation across states, because of differences in state policies allocating DSH payments, as well as geographic variation by census region.
  • Do Hospital Closures Affect Patient Time in an Ambulance?
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2019
    Our study explores how a local hospital closure changes patient time in an ambulance for 9-1-1 calls. Access to emergency department services in communities, especially rural communities, persists as a priority for the Medicare program. We found when hospitals close, rural patients requiring ambulance services are disproportionately affected.
  • Does ACA Insurance Coverage Expansion Improve the Financial Performance of Rural Hospitals?
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 04/2016
    Views on how the implementation of the ACA's expanded insurance coverage is affecting the financial performance of rural hospitals. The study found that while respondents believe the expanded insurance coverage was the right thing to do for patients, they worried coverage may not be adequate to ensure access to care.
  • Establishing a Fair Medicare Reimbursement for Low-Volume Rural Ambulance Providers
    NORC Walsh Center for Rural Health Analysis
    Date: 07/2001
    This national study of ambulance transport costs looks at the advantages and disadvantages of several options for Medicare to compensate low-volume rural ambulance providers.
  • Estimated Costs of Rural Freestanding Emergency Departments
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2015
    A rural freestanding emergency department (RFED) is one potential model for providing emergency services in areas where hospitals have closed. The North Carolina Rural Health Research Program's Findings Brief, Estimated Costs of Rural Freestanding Emergency Departments explains the RFED concept and estimates RFED costs in three scenarios.
  • Exploring the Impact of Medicare's Post-Acute Care Transfer Payment Policy on Rural Hospitals
    NORC Walsh Center for Rural Health Analysis
    Date: 07/2004
    This policy analysis brief describes a change in Medicare post-acute transfer payment policy and its impact on rural and urban hospitals. It includes data on the financial impact and hospital discharge behavior before and after the change.
  • The Financial Benefits of Critical Access Hospital Conversion for FY 1999 and FY 2000 Converters
    University of Minnesota Rural Health Research Center
    Date: 01/2004
    This paper discusses the impact of conversion to critical access hospital (CAH) status on the financial condition of rural hospitals one and two years after conversion. CAHs pre- and post-conversion revenues are compared, and CAH revenues are compared to small rural hospitals that did not convert to cost-based Medicare reimbursement.
  • The Financial Effects of Critical Access Hospital Conversion
    University of Minnesota Rural Health Research Center
    Date: 01/2003
    This paper describes how the first wave of conversions to critical access hospital status affected rural hospitals' financial performances and organizational structures.
  • Financial Incentives for Rural Hospitals to Expand the Scope of Their Services
    University of Minnesota Rural Health Research Center
    Date: 06/2002
    This paper examines the financial incentives that rural hospitals have to conduct surgery and treat more complex medical conditions. The objective is to evaluate whether rural hospitals that offer broader services are more profitable than hospitals with limited inpatient services.
  • 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.
  • Financial Viability of Rural Hospitals in a Post-BBA Environment
    University of Minnesota Rural Health Research Center
    Date: 10/2000
    This paper evaluates the financial viability of rural hospitals under the Balanced Budget Act of 1997 and the Balanced Budget Refinement Act of 1999 Medicare payment policies. It estimates the number of hospitals that will become critical access hospitals and the number of beds at each hospital.
  • Financially Distressed Rural Hospitals In Four States
    NORC Walsh Center for Rural Health Analysis
    Date: 01/2004
    The effect of the outpatient prospective payment system on the financial performance of rural hospitals was simulated in four states: Iowa, Texas, Washington, and West Virginia.
  • Financing and Payment Issues in Rural Long Term Care Integration
    Report
    Maine Rural Health Research Center
    Date: 2000
    This report reviews current research and experience and identifies key policy and program considerations for integrated acute and long-term care financing in rural areas.
  • Financing and Payment Issues in Rural Long Term Care Integration (Research & Policy Brief)
    Policy Brief
    Maine Rural Health Research Center
    Date: 02/2001
    This research and policy brief reviews current research and experience and identifies key policy and program considerations for integrated acute and long-term care financing in rural areas.
  • Financing Rural Public Health Activities in Prevention and Health Promotion (Final Report)
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2008
    This is the final report of a study to determine whether the flow of federal resources, from federal agencies, through states, and to communities, is influenced by state- and local-level public health infrastructure.
  • Geographic Variation in Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2016
    From 2005 to 2015, 112 rural hospital closures have been identified. The closures impact millions of rural residents. This brief describes the geographic variation in the proportion of rural hospitals forecasted to be at high risk of distress in 2015.
  • Geographic Variation in the 2016 Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2018
    This study describes the geographic variation in 2016 profitability of critical access hospitals (CAHs), other rural hospitals (Medicare Dependent Hospitals, Sole Community Hospitals, and rural Prospective Payment System (PPS) hospitals denoted as "ORH"), and urban PPS hospitals by census region, census division, and state.
  • Geographic Variation in the 2019 Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief investigates 2019 geographic variation in risk of financial distress among rural hospitals.
  • Geographic Variation in the Profitability of Urban and Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2016
    Historic and recent evidence suggest that unprofitability can reduce hospital services and quality, or worse, lead to closure. This study describes the current geographic variability of hospital profitability by comparing the 2014 profitability of CAHs, other rural hospitals, and urban hospitals by census region, census division, and state.
  • Geographic Variation in Uncompensated Care Between Rural and Urban Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 06/2018
    The purpose of this brief is to compare uncompensated care in rural and urban hospitals and to describe how it varies across regions of the country.
  • Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 05/2015
    Analysis of national county-level Health Insurance Marketplace (HIM) plan data for 2014 and 2015 shows there is no systematic pattern to rural experiences of HIMs, although some isolated places may be at risk for weak outcomes.
  • The High Performance Rural Health Care System of the Future
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 09/2011
    This project describes a future rural system that would be built on foundations of affordability, accessibility, community focus, high quality, and patient centeredness.
  • How Will Elimination of Hospital Bad Debt Reimbursement Affect Rural PPS Hospitals?
    Policy Brief
    NORC Walsh Center for Rural Health Analysis
    Date: 07/2007
    This policy brief examines the financial effect that changes in current Medicare bad debt payment policy, as proposed in the FY2007 budget, might have on rural hospitals.
  • Impact of CAH Conversion on Hospital Finances and Mix of Inpatient Services (Final Report)
    NORC Walsh Center for Rural Health Analysis
    Date: 08/2008
    This study examined Medicare Cost Report and claims data for hospitals before and after critical access hospital (CAH) conversion in order to better understand changes in hospital costs associated with CAH conversion, factors associated with any cost growth, and changes in the mix of services provided by the facility.
  • Impact of Conversion to Critical Access Hospital Status on Hospital Financial Performance and Condition
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2006
    This policy brief analyzes financial ratios associated with critical access hospitals' profitability, liquidity, and capital structure.
  • Impact of the Medicare Disproportionate Share Hospital Payment Cap on Urban and Rural Hospitals
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2019
    The Medicare Disproportionate Share Hospital payment adjustment is intended to compensate hospitals serving a disproportionate number of low-income patients. This policy brief describes the number and location of urban and rural hospitals affected by a 12% payment cap established by the Medicare Modernization Act of 2003.
  • Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
    Policy Brief
    Upper Midwest Rural Health Research Center
    Date: 11/2006
    This paper provides an overview of findings of a national study to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration project.
  • Medicare Accountable Care Organization Growth in Rural America, 2014-2016
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2018
    This RUPRI Center data report describes Medicare accountable care organization (ACO) growth in non-metropolitan U.S. counties from 2014 to 2016. ACOs are the most widespread of the Centers for Medicare & Medicaid Services (CMS) value-based payment programs and demonstrations.
  • Medicare Value-based Payment Reform: Priorities for Transforming Rural Health Systems
    Report
    RUPRI Health Panel: Rural Policy Analysis and Applications
    Date: 11/2015
    As Medicare moves to value-based payment, healthcare groups are made more accountable for patient health. But the changes have been concentrated in urban areas. Policies meant to strengthen rural health systems are complicating payment and delivery system reform in rural areas. This study examines ways to include rural areas in the changes.
  • National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2007
    This policy brief documents the national magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
  • Occupancy Rates in Rural and Urban Hospitals: Value and Limitations in Use as a Measure of Surge Capacity
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 03/2020
    The purpose of this brief is to provide healthcare leaders and policymakers with information about historic occupancy rates (the percent of available beds that are occupied) as an input for state and system-level planning to manage population health during a pandemic.
  • Prediction of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2016
    From 2005 to 2015, more than 100 rural hospitals have closed their doors to patients in need of inpatient services. To understand factors affecting rural hospital financial distress and to develop an early warning system to identify hospitals at risk, the North Carolina Rural Health Research Program developed the Financial Distress Index.
  • Primary Care Clinician Participation in the CMS Quality Payment
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 04/2019
    Approximately 10% of primary care clinicians participate in Advanced Alternative Payment Models (A-APMs) and less than 30% of primary care clinicians participate in the Merit-Based Incentive Payment System. Metropolitan primary care clinicians are more likely to participate in A-APMs than nonmetropolitan primary care clinicians.
  • Primer On Interpreting Hospital Margins
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 07/2003
    This document explains the most commonly used measures of hospital profitability and how they are used to inform policy changes.
  • Provision of Uncompensated Care by Rural Hospitals: A Preliminary Look at Medicare Cost Report Worksheet S-10
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 08/2013
    This brief is a preliminary assessment of uncompensated care data quality included in Medicare Cost Report Worksheet S-10 for critical access hospitals and other rural hospitals to identify data quality issue implications for research and policy decisions. Worksheet S-10 data were collected from the Healthcare Cost Reporting Information System.
  • Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 12/2007
    This policy brief estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
  • Revisions to Medicare's Disproportionate Share Payment Policy to Incorporate Bad Debt and Charity Care
    NORC Walsh Center for Rural Health Analysis
    Date: 09/2005
    This report investigates the impact of possible changes to the Medicare disproportionate share payment policy, designed to incorporate information on the hospital's uncompensated care burden as well as to improve the payment formulae.
  • Role of CAH Status in Mitigating the Effects of New Prospective Payment Systems Under Medicare
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 01/2000
    This findings brief examines rural hospitals that potentially qualify as critical access hospitals and identifies facilities at substantial financial risk as a result of Medicare's expansion of prospective payment systems to non-acute settings.
  • Rural Enrollment in Health Insurance Marketplaces, by State
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2015
    This brief compares cumulative enrollment totals in Health Insurance Marketplaces in metropolitan and non-metropolitan areas by state and the percentages of potential market participants enrolled. Non-metropolitan enrollment rates were higher in several states. The analysis shows how well outreach/enrollment efforts targeting rural areas work.
  • Rural Family Physicians Have a Broader Scope of Practice Than Urban Family Physicians
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    While the scope of practice of family physicians has been shrinking, they still practice broadly, often due to fewer health care resources in rural areas. Using data from family physicians seeking continued board certification in 2014 and 2015, we found that a high percentage of rural family physicians provide nearly every clinical service queried.
  • Rural Family Physicians in Patient Centered Medical Homes Have a Broader Scope of Practice
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 02/2018
    The Patient Centered Medical Home (PCMH) is supposed to provide accessible and comprehensive care. Using data from family physicians seeking to continue their American Board of Family Medicine certification in 2014 and 2015, we found that rural family physicians in PCMH practices generally provide more services than those in non-PCMH practices.
  • Rural Government Role in Medicaid Managed Care: The Development of County-Based Purchasing in Minnesota
    University of Minnesota Rural Health Research Center
    Date: 01/2001
    This paper describes the development and implementation in Minnesota of a model for rural county government participation in Medicaid-managed care initiatives.
  • Rural Health Clinic Costs and Medicare Reimbursement
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2019
    We used cost report data to examine Rural Health Clinic (RHC) services costs. The findings support the National Advisory Committee on Rural Health & Human Service's conclusion that the cost-based methodology used to determine Medicare reimbursement for RHCs is outdated and RHCs subject to the reimbursement cap are paid less than their costs.
  • Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing, and Home Health Care
    University of Minnesota Rural Health Research Center
    Date: 10/2001
    This study surveys 448 rural hospitals to see how they are restructuring in light of the Balanced Budget Act of 1997.
  • Rural Implications of Medicare's Post-Acute Care Transfer Payment Policy
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2004
    This study examines the behavioral and financial impacts of the initial 10-DRG policy and projects the likely financial impact of extending the policy to cover additional DRGs or discharges to swing beds.
  • Rural Public Health Financing: The Relationship Between Infrastructure and Local Program Funding
    Policy Brief
    NORC Walsh Center for Rural Health Analysis
    Date: 06/2008
    This study's purpose was to describe how federal funds for selected chronic disease prevention and health promotion activities are distributed to local health departments and non-governmental organizations at the local level and to identify infrastructure-related barriers that rural agencies may face in securing and using funds for such purposes.
  • Rural/Urban and Regional Variation in the 2019 CMS Hospital Wage Index
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 05/2019
    This brief describes the geographic variation of the 2019 Centers for Medicare & Medicaid Services hospital wage index by rural/urban definition, census region, Frontier and Remote Area codes and state.
  • Spread of Accountable Care Organizations in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 10/2016
    This brief updates a RUPRI Center analysis of the presence of Medicare Accountable Care Organizations (ACOs) in rural areas of the US in 2013. Using participation data through 2015, the current brief finds that there has been broad growth in the number of places where ACO participating providers can be found, including rural locations.
  • Spread of Medicare Accountable Care Organizations in Rural America
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 08/2018
    This policy brief describes Medicare accountable care organization (ACO) growth in non-metropolitan U.S. counties from 2016 to 2017. This brief, which includes data through December 2017, follows a similar analysis released in October 2016 that described ACO trends from 2013 to 2015.
  • The Financial Importance of the Sole Community Hospital Payment Designation
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 11/2016
    Assesses the financial importance of the Sole Community Hospital (SCH) program by: the proportion of SCHs that was reimbursed at the hospital specific rate between 2006 and 2015; the profitability of providing services to Medicare patients in SCHs between 2006 and 2015, and; the financial consequences if the SCH program had not existed in 2015.
  • The Impact of the Low Volume Hospital (LVH) Program on the Viability of Small, Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2016
    This brief compares rural Low Volume Hospital (LVH) to non-LVH characteristics and estimates the financial impact of eliminating the LVH program and reverting to the original (2005) LVH classification and payment adjustment.
  • Trends in Risk of Financial Distress Among Rural Hospitals
    Policy Brief
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 10/2016
    From January 2005 to July 2016, 118 rural hospitals have closed permanently, and the rate of rural hospital closures is increasing. Hospital closures impact millions of rural residents. Identifying hospitals at high risk of closure and assessing the trends over time may inform strategies to prevent or mitigate the effects of closures.
  • Trends in Risk of Financial Distress Among Rural Hospitals, 2015 to 2019
    Policy Brief
    Rapid Response to Requests for Rural Data Analysis
    Date: 04/2019
    This brief investigates 2015 to 2019 trends in risk of financial distress among rural hospitals by census region and Medicare payment classification.
  • Variance in the Profitability of Small-Town Rural Hospitals (Full Report)
    NORC Walsh Center for Rural Health Analysis
    Date: 02/2002
    This report documents the variance in profitability among small-town rural hospitals and evaluates the characteristics that distinguish highly profitable small-town hospitals from struggling ones. It also reports on strategies that small-town hospital administrators are using to achieve financial success.
  • Variance in the Profitability of Small-Town Rural Hospitals (Policy Brief)
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2002
    This policy brief discusses why some rural small-town hospitals are financially successful and others struggle with persistent financial difficulties.
  • Why are Health Care Expenditures Increasing and Is There a Rural Differential?
    Policy Brief
    RUPRI Center for Rural Health Policy Analysis
    Date: 11/2005
    Rising healthcare expenditures have disproportionately affected rural areas and in recent years seen higher increases in some expenditure categories, such as physician office-based visits and prescription drugs. Differences suggest strategies to contain health expenditure increases may be different in rural areas and determined on a local basis.
  • Will the Outpatient Prospective Payment System Increase the Number of Distressed Rural Hospitals in Iowa, Texas, Washington, and West Virginia?
    NORC Walsh Center for Rural Health Analysis
    Date: 01/2001
    This study simulates the financial impact of the outpatient prospective payment system rates and estimates the number and type of rural hospitals in the five states likely to become financially distressed as a result of its implementation.