This statistical brief examines inpatient stays for adults 18 years and older related to opioid use disorder (OUD) and endocarditis, stays related to OUD but not endocarditis, and stays related to endocarditis but not OUD. It includes data by patient location for metropolitan, rural adjacent to metro, and rural remote areas. Read more here.
Geographic Variation in the 2018 Profitability of Urban and Rural Hospitals
This findings brief compares the profitability of Critical Access Hospitals, other rural hospitals, and urban hospitals in 2018 by census region, census division, and state. It examines the reasons for geographic variation in the profitability of urban and rural hospitals. Read more here.
Additional links: 2016‐18 Profitability of Urban and Rural Hospitals by Medicare Payment Classification, Rural Hospitals with Long‐Term Unprofitability, Understanding the Broader Context of Rural Hospitals and Profitability
CAH Medicaid Payer Mix in Expansion vs. Non-Expansion States
This policy brief examines the change in median Medicaid payer mix among Critical Access Hospitals between 2013 and 2018 and compares the change across states that adopted Medicaid expansion and those that did not. Read more here.
One-in-Four U.S. Rural Hospitals at High Financial Risk of Closing as Patients Leave Communities for Care
Apr 8, 2020 — This article summarizes an analysis conducted before the coronavirus outbreak, that found a quarter of rural hospitals are at high risk of closing due to financial challenges. It describes how the migration of patients to care options outside the community has contributed to the situation, includes advice for rural hospitals to partner with other regional health systems and their communities. Read more here.
RAND: Responding to Critical Care Surge Capacity
The RAND Corporation (Research ANd Development) included 61 rural hospitals in its survey of hospitals across the country about their capacity to respond to the Coronavirus pandemic. The report presents a range of strategies for creating capacity, including an online Critical Care Surge Response Tool that allows decision-makers at all levels — hospitals, health care systems, states, regions — to estimate current critical care capacity and rapidly explore strategies for increasing it. Read more here.
Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties
The RUPRI Center for Rural Health Policy Analysis daily data brief on metropolitan and nonmetropolitan COVID-19 cases has been enhanced to provide additional information on cases, deaths, and rates. Also included is a new map showing counties with case rates exceeding 10 per 10,000 population and death rates exceeding 1 per 10,000 population.
New Brief: Rural Hospital Participation in Medicare Accountable Care Organizations
A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis.
This RUPRI Center policy brief summarizes national and regional rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs) and identifies factors associated with ACO participation.
Please click here to read the brief.
New Brief: Impact of CAH Participation in Flex Financial and Operations Improvement Activities on Hospital Financial Indicators
The Flex Monitoring Team has released a new policy brief, Impact of CAH Participation in Flex Financial and Operations Improvement Activities on Hospital Financial Indicators.
Under the Medicare Rural Hospital Flexibility (Flex) Program, states with Critical Access Hospitals (CAHs) are eligible to receive federal funds to support hospital improvement. In this brief, the Flex Monitoring Team explores the impact of participation in financial and operational improvement activities on key hospital financial indicators. Key findings include:
- Compared to CAHs with no participation, CAHs with two years of participation and three years of participation showed increases in total margin of 1.60 and 3.95 percentage points, respectively.
- Compared to CAHs with no participation, CAHs with three years of participation showed a 3.16 percentage point increase in operating margin.
- We found no evidence that one year of participation improved profitability indicators, suggesting that continued participation may be necessary to see changes in financial indicators.
- Because interventions were not randomly assigned, we were unable to determine whether there was a causal relationship between participation and financial performance. Results were sensitive to model specification and should be interpreted with caution.
This paper may be accessed via the link below or on the Flex Monitoring Team website.
New Brief: CAH Medicaid Payer Mix in Expansion vs. Non-Expansion States
The Flex Monitoring Team has released a new policy brief, CAH Medicaid Payer Mix in Expansion vs. Non-Expansion States. In this brief, we compare Medicaid payer mix in 2018 versus 2013 for CAHs in states that have and have not expanded Medicaid.
Since the Affordable Care Act’s (ACA) enactment of Medicaid expansion in 2014, 36 states have decided to expand Medicaid. The larger number of Medicaid patients has resulted in a substantial increase in Medicaid payer mix (the proportion of a hospital’s net patient revenue provided by Medicaid). Previous studies have found an association between Medicaid expansion and payer mix among patients hospitalized for certain conditions. This study finds a similar relationship among CAHs in expansion versus non-expansion states. CAHs with the greatest positive changes in Medicaid payer mix are located in expansion states. CAHs with the smallest or negative changes in Medicaid payer mix tend to be located in non-expansion states.
This paper may be accessed here or on the Flex Monitoring Team website.
Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017
This report examines trends in emergency department (ED) discharge opioid prescribing for adults from 2006–2007 through 2016–2017. It provides data by selected patient and hospital characteristics and the type of opioids prescribed. Table 1 includes data on the percent of ED patients prescribed an opioid at discharge by location of patient residence for metropolitan and nonmetropolitan areas. Read more here.