Tools
AHA Issues: Rural Community Hospital Demonstration Program
Web site
Description of the Rural Community Hospital (RCH) Demonstration Program, which examines the use of RCHs to provide Medicare covered inpatient hospital services in rural areas. Includes links to program transmittals and regulations.
AHA Issues: Rural Health Care
Web site
Information on American Hospital Association (AHA) advocacy activities related to rural hospitals. Includes news and resources.
AHA Quality and Patient Safety Center
Web site
A resource of the AHA to help hospitals accelerate their quality and performance improvement processes. Features tools, articles and news.
AHA Section for Small or Rural Hospitals
Web site
Information on American Hospital Association (AHA) advocacy activities on behalf of small and rural hospitals. Includes information about the Section, advocacy activities, and publications.
AHRQ Quality Indicators Toolkit for Hospitals
Web site
Helps hospitals understand the Quality Indicators (QIs) from the Agency for Healthcare Research and Quality (AHRQ), and support the use of them to successfully improve quality and patient safety in hospitals.
CMS Hospital Center
Web site
Provides updates on regulations, various hospital prospective payment systems, certification, policies, legislation, and initiatives.
CMS ICD-10 Website
Web site
Provides fact sheets, resources, timelines, and news to help vendors, payers, and providers prepare for the U.S. health care's transition to Version 5010 and ICD-10. Includes information on the 2012 ICD-10-CM diagnosis coding system. Version 5010 standards pertain to electronic health transactions and ICD-10 pertain to medical diagnosis and inpatient procedure coding.
CMS Recovery Audit Program
Web site
Provides information on the Recovery Audit program, to reduce Medicare improper payments through detection and collection of overpayments, the identification of underpayments and the implementation of actions to prevent future improper payments.
CMS Sponsored ICD-10 Teleconferences
Web site
Presents a list of archived teleconferences discussing the change to ICD-10 for medical diagnosis and inpatient procedure coding.
Community Health Needs Assessment (CHNA) Template
Web site
Created to assist 501(c)(3) hospitals conduct their community health needs assessments, which are required by the Patient Protection and Affordable Care Act (PPACA), every 3 years. The template will enable hospitals to conduct the process themselves or allow other organizations to facilitate the process for the hospitals.
Eligible ZIP Codes for Enhanced Medicare Rural Ambulance and Lab Reimbursement
Web site
A national fee schedule for ambulance services, effective for claims with dates of service on or after April 1, 2002. Applies to all ambulance services, including volunteer, municipal, private, independent, and institutional providers, such as hospitals, critical access hospitals (except when it is the only ambulance service within 35 miles), and skilled nursing facilities. Sections of this are updated yearly.
Executive Primer on Hospital Environmental Sustainability
Web site
Provides hospital managers, staff, and designers of health care facilities, information about sustainability issues relevant to hospitals.
HCUPnet
Database
Online query tool for accessing Healthcare Cost and Utilization Project data. Provides access to health statistics and information on hospital stays at the national, regional, and State level. Includes data on rural hospital diagnoses and procedures.
Health Care Facilities Mortgage Insurance for Hospitals Success Stories
Web site
Through its Section 242 mortgage insurance program, the Federal Housing Administration has supported and strengthened hundreds of hospitals and communities across the country.
Health IT - Meaningful Use Resources
Web site
Resource devoted to helping hospital leaders better understand the Medicare and Medicaid electronic health records incentive programs and their associated "meaningful use" requirements.
HealthCare Volunteer
Database
Searchable database of health care volunteering opportunities in the United States and abroad. Individuals can search for volunteer opportunities and organizations can use the site to seek health care volunteers.
HealthCare.gov Implementation Center
Web site
Materials related to the implementation of the Affordable Care Act, including regulations, authorities and requests for comment.
Hospital Classification (SCH/CAH/Rural)
Database
Offers lists of sole community hospitals (SCH), critical access hospitals (CAHs), CAH inpatient and outpatient cost to charge ratios (CCRs), plus rural hospitals under 100 beds and rural sole community hospitals under 100 beds.
Hospital Compare
Web site
Provides consumers with information on how well hospitals care for patients with specific medical conditions such as heart attacks, heart failure, or pneumonia, as well as surgical procedures.
Impact of ICD-10 on Safety Net Providers (Webinar)
Web site
Provides technical assistance and examples of how safety net providers from various settings have begun planning to comply with the new coding system for the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
Medicare Contracting Reform
Web site
Provides information and resources concerning the Part A/Part B Medicare Administrative Contractors (MACs).
National Hospital Care Survey
Web site
Discusses the new, two year hospital survey, that will describe national patterns of health care delivery in hospital-based settings and in freestanding ambulatory surgery centers.
Preparedness Resources for Healthcare Facilities
Web site
Helps hospitals and health care facilities improve preparedness for disasters and large-scale emergencies. Includes resources for long-term acute and chronic care.
Rural Health Research: Critical Access Hospitals and Rural Hospital Flexibility Program
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of Critical Access Hospitals and the Rural Hospital Flexibility Program, produced by the Office of Rural Health Policy's funded rural health research centers.
Rural Health Research: Hospitals and clinics
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of hospitals and clinics, produced by the Office of Rural Health Policy's funded rural health research centers.
State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals
Web site
Provides a pull-down menu by state, searchable by hospital type. Includes public, sole, large, mid-size, and small hospital groups.
Sustainability Roadmap for Hospitals: A Guide to Achieving Your Sustainability Goals
Web site
Provides health care executives with information and tools that can help reduce the environmental footprint of health care facilities.
TeamSTEPPS Tools and Materials
Web site
Is an evidence-based teamwork system aimed at optimizing patient outcomes by improving teamwork skills among health care professionals. It includes a comprehensive set of ready-to-use materials and training curricula necessary to integrate teamwork principles successfully into your health care system.
UND Center for Rural Health Communication Toolkit
Web site
Provides resources and guidance to help rural health care facilities and organizations promote their services and organizations through the media.
WhyNotTheBest.org
Web site
Tracks performance on various measures of health care quality. Enables organizations to compare their performance against that of their peers in both rural and urban locations.
Regulations, Forms & Other Useful Documents
2008 Rural Hospital Renovation Study
Author(s): Bill Wilson
Summarizes the results of a survey on the impact of community hospital renovations on health care delivery and recruiting.
Date: 10 / 2008
2011 Report to the Secretary: Rural Health and Human Services Issues
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
Report to the Secretary of the U.S. Department of Health and Human Services. Includes chapters focused on rural childhood obesity, place-based initiatives for rural early childhood development, and rural implications of accountable care organizations and payment bundling. Includes recommendations to address these issues. Includes appendices regarding June 2010 and September 2010 site visits.
Date: 03 / 2011
2012 AHA Environmental Scan
Sponsoring organization: American Hospital Association
Provides information about market forces that affect the health care field. Helps hospital and health system leaders understand the health care landscape and the issues and trends their organizations likely will face in the foreseeable future.
Date: 09 / 2011
340B Drug Pricing Program: Results of a Survey of Eligible but Non-Participating Rural Hospitals
Author(s): Andrea Radford, Rebecca Slifkin, Marianne Baernholdt, Claudia Schur, Karen Cheung
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Summarizes the results of a survey of pharmacy directors at rural hospitals eligible to participate in the 340B program but identified as not participating at the time of the survey. Studies why rural hospitals that are eligible for the program are not participating and if there are barriers to participation.
Date: 01 / 2007
340B Drug Pricing Program: Results of a Survey of Participating Hospitals
Author(s): Claudia Schur, Karen Cheung, Andrea Radford, Rebecca Slifkin, Marianne Baernholdt
Presents the results of a survey of pharmacy directors at rural hospitals currently buying discounted outpatient drugs through the 340B program. The purpose was to understand the perspectives of pharmacy directors on the 340B program in general, the financial impact of the program, and which specific program features presented barriers to its broader implementation. A joint paper from the NORC Walsh Center for Rural Health Analysis and North Carolina Rural Health Research & Policy Analysis Center.
Date: 05 / 2007
Acute Care Hospital Inpatient Prospective Payment System: Payment System Fact Sheet Series
Sponsoring organization: Centers for Medicare and Medicaid Services
Provides general information about the Acute Inpatient Prospective Payment System (IPPS) including IPPS payment rates and how IPPS payment rates are set.
Date: 02 / 2012
Alternatives to the Outpatient Prospective Payment System: Assessing the Impact on Rural Hospitals
Author(s): Janet Pagan-Sutton, Claudia Schur, Katie Merrell
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Explores alternatives to the Outpatient Prospective Payment System and how these options would affect rural hospitals.
Date: 04 / 2010
Assessing the Financial Effect of Medicare Payment on Rural Hospitals: Does the Source of Data Change the Results?
Author(s): Li-Wu Chen, Susan Puumala, Keith J. Mueller, Liyan Xu, Kathy Minikus, Catherine Makhanu,
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes how predictions of changes
in hospital financial performance as a result of change in Medicare payment differ when comparing results using data from the Medicare Cost Report (MCR) to results using data from the audited hospital financial statement.
Date: 11 / 2005
Balanced Scorecards for Small Rural Hospitals: Concept Overview and Implementation Guidance
Sponsoring organization: Health Resources and Services Administration
Describes the process of implementing a Balanced Scorecard (BSC) initiative in a small rural hospital setting. Includes a Balanced Scorecard example. Lists common terminology with definitions.
Date: 2005
Beyond Health Care: The Economic Contribution of Hospitals
Sponsoring organization: American Hospital Association
Discusses economic impact of hospitals to communities, including rural communities.
Date: 04 / 2008
Care Transitions: “Time to Come Home” (Full Report)
Author(s): Shailendra Prasad, Jill M. Klingner, Ira Moscovice
Sponsoring organization: Upper Midwest Rural Health Research Center
Examines care coordination with a focus on the transitions from inpatient care back to the rural community and suggests ways of measuring the quality of care coordination on discharge from the hospital.
Date: 03 / 2011
Communities Served by Rural Medicare Dependent Hospitals
Author(s): Kristin L. Reiter, George M. Holmes, Saleema A. Karim, George H. Pink
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Explores the potential consequences of termination of the Medicare Dependent Hospital (MDH) program by comparing MDHs to rural prospective payment system hospitals (R-PPS) in terms of utilization and the characteristics of the communities they serve.
Date: 03 / 2012
Comparison of Rural Hospitals with Special Medicare Payment Provisions to Urban and Rural Hospitals Paid Under Prospective Payment (Final Report)
Author(s): G. Mark Holmes, George H. Pink, Sarah A. Friedman, Hilda A. Howard
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Compares the financial performance and condition of rural hospitals with special Medicare payment provisions to urban and rural hospitals paid under prospective payment (U-PPS and R-PPS hospitals, respectively).
Date: 08 / 2010
Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors
Author(s): Arianne N. Callender, Douglas A. Hastings, Michael C. Hemsley, Lewis Morris, Michael W. Peregrine
Sponsoring organization: U.S. Department of Health and Human Services
Resource guide designed to help health care organization boards ask appropriate questions related to health care quality requirements, measurement tools, and reporting requirements.
Date: 2007
Critical Access Hospitals and Meaningful Use of Health Information Technology
Author(s): Jeffrey McCullough, Michelle Casey, Ira Moscovice
Sponsoring organization: Flex Monitoring Team
Assesses the availability of health information technology applications that are preconditions for meaningful use in CAHs, compared to other U.S. hospitals in 2008.
Date: 02 / 2010
Does Hospital Size Affect Our Ability to Accurately Identify High Quality Care in Pay-for-Performance Programs?
Sponsoring organization: Upper Midwest Rural Health Research Center
Discusses the issue that smaller hospitals experience much greater variability in performance scores as a result of statistical sampling characteristics than larger hospitals.
Date: 05 / 2007
Economic Crisis: The Toll on the Patients and Communities Hospitals Serve
Author(s): American Hospital Association
Sponsoring organization: American Hospital Association
Interprets the results of an AHA survey of 1,078 U.S. community hospitals conducted in March 2009 about the effects of the economic downturn on patients and providers.
Date: 04 / 2009
Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia (Final Report)
Author(s): Marilyn G. Klug, Kyle Muus
Sponsoring organization: Upper Midwest Rural Health Research Center
Explores the relationship between potentially preventable hospital readmissions and a) use of outpatient follow-up care, b) discharge destination, c) rural versus urban residence of the patient, and d) time to follow-up care.
Date: 03 / 2012
Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia (Policy Brief)
Author(s): Marilyn G. Klug, Kyle Muus
Sponsoring organization: Upper Midwest Rural Health Research Center
Emphasizes the importance of receiving timely post-discharge outpatient care and appropriate discharge destination for reducing preventable hospital readmissions, especially but not exclusively among rural-based patients.
Date: 03 / 2012
Emergency Department Visits for Adults in Community Hospitals, 2008
Author(s): Pamela L. Owens, Ryan Mutter
Sponsoring organization: Agency for Healthcare Research and Quality
Uses statistics from the 2008 Nationwide Emergency Department Sample, to analyze rates of emergency room visits. Compares data by demographics, acute vs. chronic care, rural vs. urban, high-income vs. low-income, and admissions vs. treat-and-release.
Date: 11 / 2010
Fact Sheet: Hospital Reclassifications
Sponsoring organization: Centers for Medicare and Medicaid Services
Includes information about urban to rural reclassification, geographic reclassification, and Rural Referral Center status.
Date: 08 / 2011
Fact Sheet: Medicare Shared Savings Program and Rural Providers
Sponsoring organization: Centers for Medicare and Medicaid Services
Provides an overview of Accountable Care Organizations (ACOs) for rural providers. Discusses rules to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients.
Date: 10 / 2011
Fact Sheet: Rural Hospitals Struggle to Attract Patients and Remain Viable
Author(s): Elizabeth Maggio
Sponsoring organization: RAND Corporation
Describes the characteristics of rural hospitals and those who use them and discusses the challenges these hospitals face.
Date: 2009
Factors Influencing Rural Residents’ Utilization of Urban Hospitals
Author(s): Margaret Jean Hall, Jill Marsteller, Maria Owings
Sponsoring organization: Centers for Disease Control and Prevention
Examines which patient, hospital, and county characteristics influence rural residents’ use of urban hospitals.
Date: 11 / 2010
FAQs: Versions 5010 and D.O Transition Basics
Sponsoring organization: Centers for Medicare and Medicaid Services
Answers frequently asked questions regarding the transition to Version 5010 and D.O software. Version 5010 pertains to standards for electronic administrative transactions. D.O is the version of the National Council for Prescription Drug (NCPDP) standards for pharmacy transactions that replaces version 5.1.
Date: 07 / 2011
Far From the City: Community Orientation and Responsiveness of Rural Hospitals
Sponsoring organization: Upper Midwest Rural Health Research Center
Reports the findings of a national study focused on variation in hospital community orientation and responsiveness across differing rural contexts.
Date: 05 / 2008
Focus on Healthcare Finance White Paper II: Financing Options for Nonprofit Small and Rural Hospitals
Author(s): Matthew J. Lindsay, Gerald M. Swiacki
Sponsoring organization: Lancaster Pollard
Outlines several programs and financial options available to non-profit community and rural hospitals. Discusses a hospital's strategic plan for future and financial operations.
Date: 2011
From Hospitals to Healthcare Coalitions: Transforming Health Preparedness and Response in Our Communities
Sponsoring organization: U.S. Department of Health and Human Services
Summarizes progress that States and hospitals, along with the public health and emergency management communities made from 2007-2009 in the Hospital Preparedness Program (HPP). Serves as a guide in healthcare preparedness and response successful models and as an educational tool for legislators, funding recipients and other key stakeholders.
Geographic Differences in Potentially Preventable Readmission Rates in Rural and Urban Hospitals (Final Report)
Author(s): Marilyn G. Klug, Alana Knudson, Kyle Muus
Sponsoring organization: Upper Midwest Rural Health Research Center
Presents a study that estimated Potentially Preventable Hospital Readmissions (PPRs) in three types of acute care hospitals: urban prospective payment system (PPS) hospitals, rural PPS hospitals, and Critical Access Hospitals (CAHs).
Date: 11 / 2010
Guide to Financing Strategies for Hospitals: With Special Consideration for Smaller Hospitals
Sponsoring organization: Health Research & Educational Trust
Explores seven strategies that help hospitals achieve the good capital access. Provides considerations related specifically to smaller organizations, such as rural hospitals, critical access hospitals, and stand-alone community hospitals.
Date: 12 / 2010
Health Care Leader Action Guide to Reduce Avoidable Readmissions
Author(s): Osei-Anto A, Joshi M, Audet AM, Berman A, Jencks S
Sponsoring organization: Health Research & Educational Trust
Serves as a starting point for hospital leaders to assess, prioritize, implement, and monitor strategies to reduce avoidable readmissions.
Date: 01 / 2010
Health Reform In Depth: Small + Rural Hospitals
Author(s): Lee Ann Jarousee
Sponsoring organization: American Hospital Association
Presents challenges and opportunities for small and rural hospitals regarding health reform.
Journal citation: Hospitals and Health Networks
Date: 01 / 2011
Hospital Language Services for Patients With Limited English Proficiency: Results From a National Survey
Author(s): Romana Hasnain-Wynia, Julie Yonek, Debra Pierce, Ray Kang, Cynthia Hedges Greising
This report describes current practices, common
barriers, and the specific resources and tools
needed to provide language services to patients
with LEP. The results of the survey will inform
federal policymakers, practitioners, providers, and others of the issues and potential solutions facing hospitals as they work to improve language
services for all patients with LEP.
Date: 10 / 2006
Hospital Quality Improvement: Strategies and Lessons From U.S. Hospitals
Author(s): Sharon Silow-Carroll, Tanya Alteras, Jack A. Meyer
Sponsoring organization: Commonwealth Fund
Focuses on the dynamics of hospital performance: how hospitals achieve and sustain improvements over time.
Date: 04 / 2007
Hospital Readiness for Population-Based Accountable Care
Sponsoring organization: Health Research & Educational Trust
Provides hospital leaders with a snapshot of hospitals' current readiness to participate in an Accountable Care Organization (ACO), as well as a tool with which to gauge their own organizations' relative preparedness for ACO participation. Includes rural throughout report.
Date: 05 / 2012
Hospital Size, Uncertainty and Pay-for-Performance
Author(s): Gestur Davidson, Ira Moscovice, Denise Remus
Sponsoring organization: Upper Midwest Rural Health Research Center
Discusses hospital quality issues, hospital size, and pay-for-performance.
Date: 02 / 2007
How Will Elimination of Hospital Bad Debt Reimbursement Affect Rural PPS Hospitals?
Author(s): Janet P. Sutton, Alene Kennedy, Lucia Hammer, Grace Yang
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Policy brief which examines the financial effect that changes in current Medicare bad debt payment policy might have on rural hospitals.
Date: 07 / 2007
Impact of Freestanding Ambulatory Surgery Centers on Rural Community Hospital Performance, 1997–2006 (Final Report)
Author(s): Walter Gregg, Douglas Wholey, Ira Moscovice
Sponsoring organization: Upper Midwest Rural Health Research Center
Describes the impact of Ambulatory Surgery Centers (ASCs) on rural hospital markets.
Date: 10 / 2010
Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
Author(s): Walter Gregg, Ira Moscovice, Denise Remus
Sponsoring organization: Upper Midwest Rural Health Research Center
Reports the findings of a national study designed to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration Project.
Date: 09 / 2006
Implementing A New USDA Rural Development Program Targeting Small Rural Hospitals and Their Communities: Recommendations of the RUPRI Health Panel
Author(s): Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Lists recommendations for implementing a new USDA
Rural Development program, included in the Senate Farm Bill proposal, should it be enacted into law. The goal of this program is to strengthen rural health care delivery systems, to provide necessary health care services to rural residents in a cost-effective manner.
Date: 03 / 2008
Importance of Community Partnerships
Sponsoring organization: American Hospital Association
Spotlights hospitals and health systems that have successfully collaborated with local community organizations to promote care coordination, wellness, and prevention. Among the entities featured include rural hospitals and community health centers.
Date: 12 / 2010
Innovators' Guide to Navigating Medicare
Sponsoring organization: Centers for Medicare and Medicaid Services
Discusses processes used to determine coverage, coding, and payment for new technologies under the Medicare fee-for-service program. Guide is intended as a general summary.
Date: 2010
Inpatient Stays in Rural Hospitals, 2007
Author(s): Elizabeth Stranges, Laurel Holmquist, Roxanne M. Andrews
Sponsoring organization: Agency for Healthcare Research and Quality
Presents data from the Healthcare Cost and Utilization Project (HCUP) on rural hospital stays in 2007.
Date: 01 / 2010
Is Your Hospital’s Board Prepared to Govern? Rural Acute Care Hospital Boards of Directors: Education and Development Needed
Author(s): Janice C. Probst, Royce Adams, Amy B. Martin
Sponsoring organization: South Carolina Rural Health Research Center
Examines the structural, leadership, and educational needs of rural hospital boards, as viewed by rural hospital board chairs and chief executive officers (CEOs).
Date: 06 / 2010
Keeping Your Hospital Property Smoke-Free: Successful Strategies for Effective Policy
Sponsoring organization: Joint Commission
Describes strategies to assist hospitals, both rural and urban, with the implementation and enforcement of a smoke-free policy.
Date: 04 / 2011
Measuring Efficiency: The Association of Hospital Costs and Quality of Care
Author(s): Ashish K. Jha, E. John Orav, Allen Dobson, Robert A. Book, Arnold M. Epstein
Sponsoring organization: Commonwealth Fund
Reviews a study exploring the relationship between cost and quality of care in more than 3,700 U.S. hospitals, including rural hospitals, treating Medicare patients.
Date: 05 / 2009
Medicare Dependent Hospital: Rural Health Fact Sheet Series
Sponsoring organization: Centers for Medicare and Medicaid Services
Provides information about Medicare Dependent Hospitals (MDH), including classification criteria, MDH payments, and resources.
Date: 11 / 2011
Medicare Disproportionate Share Hospital: Rural Health Fact Sheet Series
Sponsoring organization: Centers for Medicare and Medicaid Services
Presents an overview of the Medicare Disproportionate Share Hospital adjustment provision and lists how a hospital can qualify to receive it.
Date: 11 / 2011
Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Sponsoring organization: Medicare Payment Advisory Commission
Overview of Medicare payments to hospitals for acute inpatient care. Include information on Medicare payments for medical education, payments to disproportionate share (DSH) hospitals, and special payments for rural hospitals.
Date: 10 / 2011
Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Final Rule
Sponsoring organization: Centers for Medicare and Medicaid Services
Revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs. Implements
certain provisions made by the Deficit Reduction Act of 2005 (Pub. L. 109–171), the Medicare Improvements and Extension Act under Division B, Title I of the Tax Relief and Health Care Act of
2006 (Pub. L. 109–432), and the Pandemic and All Hazards Preparedness Act (Pub. L. 109–417). In the Addendum to this final rule with comment period, describes changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs.
Journal citation: Federal Register Volume 72 Issue 162 Pages: 47129-48175
Date: 08 / 2007
MedPAC Report to Congress: Regional Variation in Service Use, January 2011
Sponsoring organization: Medicare Payment Advisory Commission
Presents data on the difference between regional variation in Medicare spending and regional variation in the use of Medicare-covered services. Data used was adjusted due to differences in small rural hospital and critical access hospital Medicare payment rates.
Date: 01 / 2011
National Health Service Corps Site Reference Guide
Sponsoring organization: Health Resources and Services Administration
Provides clarity on NHSC site eligibility requirements, qualification factors, compliance, roles and responsibilities, as well as a number of other key elements on becoming an NHSC-approved site. Serves as an additional resource to supplement the information contained in the Site Application and the Site Application Instructions.
Date: 03 / 2012
National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Documents the national magnitude of charges associated with hospitalizations
due to ambulatory care sensitive conditions in rural hospitals.
Date: 12 / 2007
New Hospital Information Technology: Is it Helping to Improve Quality?
Author(s): Suzanne Felt-Lisk
Sponsoring organization: Mathematica Policy Research, Inc.
Study included a nationally representative survey of hospitals that asked senior hospital executives whether clinicians use six specific types of information technology (IT). The survey also assessed whether IT had advanced quality of care, and if so, the most important ways in which it had done so.
Date: 05 / 2006
Nurse Staffing and Rural Hospital Performance (Policy Brief)
Author(s): Gestur Davidson, Kathy Belk, Ira Moscovice
Sponsoring organization: Upper Midwest Rural Health Research Center
Examines the impact of nurse staffing on rural hospital performance improvement in the CMS/Premier Inc. Hospital Quality Incentive Demonstration project.
Date: 12 / 2010
Opportunities and Challenges for Rural Hospitals in an Era of Health Reform
Sponsoring organization: American Hospital Association
Examines the challenges, including financial and workforce resources, facing rural hospitals as they implement the Patient Protection and Affordable Care Act.
Journal citation: TrendWatch
Date: 04 / 2011
Patient Assessments and Quality of Care in Rural Hospitals (Final Report)
Author(s): Michelle Casey, Gestur Davidson
Sponsoring organization: Upper Midwest Rural Health Research Center
Analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care.
Date: 06 / 2010
Performance Management: Improving and Sustaining Performance in Rural Hospitals
Author(s): Terry J. Hill
Sponsoring organization: Center for Rural Policy and Development
Outlines strategies and frameworks for overcoming obstacles in order to maintain financial stability for small rural hospitals and to establish sustainable health systems for the future.
Journal citation: Rural Minnesota Journal Volume 2 Issue 2
Date: 2007
Potentially Preventable Readmissions in Rural Hospitals (Policy Brief)
Author(s): Marilyn G. Klug, Kyle Muus, Michelle Casey, Ira Moscovice
Sponsoring organization: Upper Midwest Rural Health Research Center
Examines potentially preventable readmission rates for rural and urban hospitals, and discusses the rural implications of policy initiatives to reduce readmission rates.
Date: 08 / 2009
Prevalence of Evidence-Based Safe Medication Practices in Small Rural Hospitals
Author(s): Gary Cochran, Katherine Jones, Liyan Xu, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes the prevalence of evidence-based safe medication practices, including the use of voluntary medication error reporting, in small rural hospitals.
Date: 04 / 2008
Profitability of Rural Hospitals Paid Under Prospective Payment Compared to Rural Hospitals with Special Medicare Payment Provisions (Findings Brief)
Author(s): G. Mark Holmes, George H. Pink, Hilda A. Howard
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Compares the profitability of urban and rural hospitals paid under PPS (U-PPS and R-PPS, respectively) to rural hospitals with special Medicare payment provisions between 2007 and 2009.
Date: 09 / 2010
Providing Underserved Patients with Medical Homes: Assessing the Readiness of Safety-Net Health Centers
Author(s): Katie Coleman, Kathryn Phillips
Sponsoring organization: Commonwealth Fund
Surveys safety-net health centers (public hospitals and clinics, federally qualified health centers, rural health centers, and free clinics for the medically underserved) to determine their potential to become patient-centered medical homes (PCMHs).
Date: 05 / 2010
Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing? (Final Report)
Author(s): Laura-Mae Baldwin, Leighton Chan, C. Holly A. Andrilla, Edwin Huff, L. Gary Hart
Sponsoring organization: WWAMI Rural Health Research Center
Compared the quality of care between admissions to hospitals associated with urban and three levels of rural locations as defined by RUCA codes.
Date: 03 / 2010
Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
Date: 12 / 2007
Rising to the Challenge: Results from a Scorecard on Local Health System Performance, 2012
Author(s): David Radley
Sponsoring organization: Commonwealth Fund
Provides U.S. communities with comparative data to assess the performance of their health care systems. Tracks 43 indicators of health system performance including access, prevention and treatment, costs and potentially avoidable hospital use, and health outcomes.
Date: 03 / 2012
Rural Acute Care Hospital Boards of Directors: CAH’s Lag in Oversight
Sponsoring organization: South Carolina Rural Health Research Center
Explores the structural, leadership, and educational needs of rural hospital boards.
Date: 2010
Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions in the United States, by Insurance Type, 2000 to 2004
Author(s): Wanqing Zhang, Li-Wu Chen, Tao Li, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Examines the trends and regional variations of rural hospital charges due to ambulatory care sensitive conditions.
Date: 08 / 2011
Rural Hospital Quality Leadership Summit: Building and Sustaining Quality Leadership in Rural Hospitals
Sponsoring organization: National Rural Health Resource Center
Includes the outcome of a December 2010 forum of experts from Flex Programs, rural hospital networks, critical access hospitals, hospital and rural health associations, researchers, consultants, and federal representatives who met to discuss rural hospital quality improvement and leadership.
Date: 2011
Rural Hospital Replacement Facility Study, 2011
Sponsoring organization: Stroudwater Associates
Studies Critical Access Hospitals (CAHs) operating in replacement facilities. Addresses the impact associated with a new facility, including patient volumes, operating efficiency, and financial impacts.
Date: 2012
Rural Hospital Support for Emergency Medical Services (Final Report)
Author(s): Victoria A. Freeman, Hilda A. Howard, Ruth Lavergne
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Discusses the proportion of rural hospitals who support or operate EMS units, financial investments made by these hospitals in EMS, and communities in which these hospitals are located.
Date: 11 / 2010
Rural Hospitals' Strategies for Achieving Compliance with HIPAA Privacy Requirements
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Discusses a survey of hospital administrators in rural areas regarding the Health Insurance Portability and Accountability Act (HIPAA). Includes an overview of HIPAA compliance efforts in rural hospitals, as well as examples of specific strategies to meet HIPAA requirements.
Date: 03 / 2004
Rural Issues Related to Bundled Payments for Acute Care Episodes (Policy Brief)
Author(s): Robert Town, Walter Gregg, Ira Moscovice, Shailendra Prasad, Jill Klingner, Christopher Dickerson
Sponsoring organization: Upper Midwest Rural Health Research Center
Describes challenges to implementing bundled payments in rural settings and discusses potential contracting and reimbursement strategies to address these challenges.
Date: 06 / 2009
Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act Of 2003 (MMA)
Author(s): Curt Mueller, Keith Mueller, Janet Sutton
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Identifies sections of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) that might be of special concern to rural Medicare beneficiaries, medical care providers, and policymakers. Includes guidance regarding provisions in the Proposed Rule "Establishment of the Medicare Advantage Program," which implements Title II of the MMA, with a focus on its impact on rural health service delivery.
Date: 08 / 2004
Rural Referral Center: Rural Health Fact Sheet Series
Sponsoring organization: Centers for Medicare and Medicaid Services
Provides information on the Rural Referral Center (RCC) program, which supports high-volume rural hospitals that treat a large number of complicated cases. Includes list of CMS Regional Office Rural Health Coordinators.
Date: 01 / 2011
Rural Spotlight: An Interview with John Supplitt
Author(s): Beth Blevins
Sponsoring organization: Rural Assistance Center
Presents an interview with the senior director of the Section for Small or Rural Hospitals of the American Hospital Association. Discusses challenges facing rural hospitals, workforce, and HIT.
Journal citation: Rural Monitor
Date: 02 / 2011
Rurals at a Crossroads
Author(s): Susan Stowell, James Puiia
Sponsoring organization: Health Forum
Offers leaders of rural hospitals ways to assess opportunities and develop strategies that will enable their hospitals to remain relevant during and following the redesign of the health care delivery system.
Date: 01 / 2011
Section for Small or Rural Hospitals: 2009 Year in Review
Sponsoring organization: American Hospital Association
Highlights some of the legislative and regulatory issues the AHA championed on behalf of small or rural hospital members.
Date: 2009
Sole Community Hospital: Rural Health Fact Sheet Series
Sponsoring organization: Centers for Medicare and Medicaid Services
Presents information on Sole Community Hospitals including classification payments and criteria, resources, and a list of regional office rural health coordinators.
Date: 11 / 2011
Teaching Hospitals: Their Impact on Patients and the Future Health Care Workforce
Sponsoring organization: American Hospital Association
Provides details about the role America's teaching hospitals play in the nation's health care system. Discusses that, in addition to training future physicians and health professionals, teaching hospitals conduct lifesaving research and provide specialized services not offered at other facilities.
Date: 09 / 2009
Transforming Hospitals: Designing for Safety and Quality
Sponsoring organization: Agency for Healthcare Research and Quality
Reviews the case for evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, and employee retention, and results in a positive return on investment.
Date: 09 / 2007
Trends in the Provision of Surgery by Rural Hospitals
Author(s): George M. Holmes, Saleema A. Karim, George H. Pink
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Reports that the number of rural hospitals that did not provide surgery increased between 2001 and
2008.
Date: 07 / 2011
Two Days In December: A Report from the Rural Hospital Quality Leadership Summit
Author(s): Bob Hartl, Toni Pearson
Sponsoring organization: National Rural Health Resource Center
Includes a summary of the Rural Hospital Quality Leadership Summit held in December 2010 in Minneapolis, MN.
Date: 2011
Use of Hospitalists in Small Rural Hospitals
Sponsoring organization: Upper Midwest Rural Health Research Center
Describes the results of a survey of small rural hospitals that use hospitalists, who are physicians, physician assistants or nurse practitioners who assume responsibility for patient care during inpatient hospital stays.
Date: 04 / 2012
Why Use Swing Beds? Conversations with Hospital Administrators and Staff (Findings Brief)
Author(s): Victoria A. Freeman, Andrea Radford
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center
Includes interviews of hospital administrators and staff about the use of swing beds including the role of swing beds in patient care, swing bed volume and financial considerations, swing beds in the context of all community post-acute skilled care and swing beds as a benefit for community residents.
Date: 04 / 2012
Terms & Acronyms
Co-location Different health units, such as a CAH and a FQHC, situated on the same site sharing resources and facilities.
Critical Access Hospital (CAH) Rural hospitals with fewer than 25 acute care beds located at least 35 miles, or 15 by mountainous terrain or secondary roads, from the nearest hospital unless designated as a “Necessary Provider” by a state plan.
Disproportionate Share Adjustment (DSH) Additional payment to hospitals that serve a disproportionate share of low-income patients, based on a formula which involves the calculation of a disproportionate share adjustment factor that is multiplied by the amount of federal DRG payments.
DRG (Diagnosis-related Groups) Reimbursement method where the hospital receives a fixed payment for each type of medical procedure, regardless of the hospital's cost.
ICD-10 (International Statistical Classification of Diseases and Related Health Problems) The 10th version of the International Statistical Classification of Diseases and Related Health Problems. Medical classification list for the coding of diseases, signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the World Health Organization. Comprised of over 14,000 codes and permits the tracking of many new diagnoses.
Medicare Dependent Hospital (MDH) Rural hospitals from whom Medicare represents at least 50% of all inpatient revenue.
Medicare Rural Hospital Flexibility Program (Flex Program) Federal initiative created by the Balanced Budget Act of 1997 that provides funding to State Governments to strengthen rural health. Requires the development of state rural health plan. Provides funding to States network development, quality improvement, designation of Critical Access Hospitals (CAHs), and improvement of rural EMS.
Provider A doctor, hospital, health care professional, or health care facility.
Quality Improvement Organization (QIO) QIOs review Medicare services. They work with consumers, physicians, hospitals, and other caregivers to make sure patients get the right care at the right time, particularly among underserved populations.
Rural Health Clinic (RHC) Clinic certified to receive special Medicare and Medicaid reimbursement. RHCs must be located in underserved rural areas and provide primary care services. RHCs use a team approach of physicians, nurse practitioners, physician assistants, and certified nurse midwives to provide services. Payment is based on a cost-related basis for outpatient physician and certain nonphysician services.
Rural Referral Center (RRC) Rural tertiary hospitals who receive referrals from surrounding small primary care hospitals. An acute care hospital can be classified as an RRC if it meets several criteria pertaining to location, bed size, and referral patterns.
Sole Community Hospital (SCH) Rural hospitals with fewer than 50 acute care beds located at least 50 miles from the nearest hospital. Medicare payment to these hospitals is based on either their own historical costs or the PPS.
Swing beds Licensed acute-care beds designated by a hospital to provide either acute or long-term care services. A swing bed hospital is a hospital or critical access hospital (CAH) participating in Medicare that has CMS approval to provide post-hospital skilled nursing facility care and meets certain requirements.
Trauma Center A specialized hospital facility distinguished by the immediate availability of specialized surgeons, physician specialists, anesthesiologists, nurses, and resuscitation and life support equipment on a 24 hour basis to care for severely injured patients or those at risk for severe injury.
Version 5010 Also referred to as HIPAA X12 Version 5010. This is a new set of standards that regulates the electronic transmission of specific healthcare transactions. Covered entities, such as health plans, health care clearinghouses, and health care providers, are required to conform to these standards. The deadline date for this change has been changed several times. Currently, the deadline is after June 20, 2012.
Version D.O This is the new version of the National Council for Prescription Drug Programs (NCPDP) standards for pharmacy transactions that replaces version 5.1. Mandatory compliance date is January 1, 2012.
