PHC4 Produces Special Report on the Financial Health of Hospitals in Rural Pennsylvania

For the first time, PHC4 has released a public report shedding light on the finances of rural hospitals in Pennsylvania.

PHC4’s Special Report on the Financial Health of Pennsylvania Rural Hospitals, Fiscal Year 2023, displays data for general acute care hospitals (GAC hospitals) located in rural counties, as defined by the Center for Rural Pennsylvania. Those hospitals fitting this definition within PHC4’s Financial Analysis 2023 Volume One report are included in this new resource.

The analysis shows that during Fiscal Year 2023 (FY23), there were 64 (41%) GAC hospitals located in a rural county. Of these GAC hospitals, 31 (48%) operated at a loss based on operating margins during FY23 and 28 (44%) operated at a loss based on total margins during FY23. The average net patient revenue for these hospitals operating at a loss was $107 million in FY23.

Barry D. Buckingham, PHC4’s Executive Director, suggests that the financial challenges of rural hospitals may have significant implications for health care access in rural areas. Buckingham states, “As rural hospitals close or reduce services due to financial pressures, residents of these areas may face longer travel times to access care, reduced availability of emergency services, and a potential general decline in the quality of health or health care services.” Rural hospitals often operate in geographically isolated areas, serving smaller populations with higher percentages of elderly and low-income individuals. Other contributing factors to the data displayed may include:

  • Decreased Reimbursements: Lower payments from government programs like Medicare and Medicaid, as well as private insurers, have put a strain on rural hospitals’ finances.
  • Aging Populations: Many rural areas have an aging population, which often requires more complex and expensive care.
  • Hospital Volume: Rural hospitals often serve smaller populations, which can make it difficult to generate enough revenue to cover costs.
  • Higher Operating Costs: Rural hospitals may face higher operating costs due to factors such as transportation, staff shortages, and the need to maintain specialized services.
  • Economic Challenges: Rural communities often face economic challenges, which can impact the ability of residents to pay for health care.

For more information, visit phc4.org. To review the full report and interactive data visualizations click here.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.  

Reducing Sugar-Sweetened and Acidic Beverage Consumption: Pilot Project

The PA Coalition for Oral Health and the Pennsylvania Department of Health Oral Health Program are working together on a multimedia communications campaign for 11–17-year-olds on reducing sugar-sweetened and acidic beverage consumption in certain PA counties.

The project is multifaceted, consisting of a social media campaign, as well as print materials to be displayed in-office/in the waiting room, and an interactive demonstration. They are looking for clinics in Allegheny, Berks, Centre, Clarion, Crawford, Jefferson, Lancaster, or Lehigh counties that would be able to display the print materials and conduct the interactive demonstration at one community event this spring. If spacing is an issue, the sugar-sweetened beverage materials and acid materials can be displayed separately.

The PA Coalition for Oral Health are asking that materials be displayed from March 3, 2025- May 30, 2025, and that during at least one community event during that time, you complete the acid interactive demonstration. All materials will be mailed to you free of charge and are yours to keep at the end of the campaign. The materials that would be displayed in your office/waiting room are:

Please email Lia BenYishay by Wednesday, Feb.26, 2025 if you’re interested or if you have any follow-up questions.

100 Top Critical Access Hospitals Listed, By State

The Chartis Center for Rural Health released its annual list of the top 100 critical access hospitals in the U.S. on February 12.

To determine the 2025 list, the firm used the Chartis Rural Hospital Performance INDEX, which assesses performance in inpatient market share, outpatient market share, quality, outcomes, patient perspective, cost, charge and finance.

Here are the top 100 critical access hospitals in the U.S., listed by state:

Arkansas

  • Mercy Hospital Paris

Colorado

  • East Morgan County Hospital (Brush)
  • Kit Carson County Memorial Hospital (Burlington)
  • Mt. San Rafael Hospital (Trinidad)
  • Rio Grande Hospital (Del Norte)
  • Wray Community District Hospital

Florida

  • Calhoun Liberty Hospital (Blountstown)

Iowa

  • Cass Health (Atlantic)
  • CHI Health Missouri Valley
  • Clarke County Hospital (Osceola)
  • Floyd Valley Healthcare (Le Mars)
  • Greater Regional Medical Center (Creston)
  • Grundy County Memorial Hospital (Grundy Center)
  • Hancock County Memorial Hospital (Britt)
  • Loring Hospital (Sac City)
  • UnityPoint Health Jones Regional Medical Center (Anamosa)
  • Van Diest Medical Center (Webster City)
  • Washington County Hospital (Washington)

Idaho

  • Shoshone Medical Center (Kellogg)
  • St. Luke’s Wood River Medical Center (Ketchum)

Kansas

  • Artesian Valley Health System (Meade)
  • Clay County Medical Center (Clay Center)
  • Community Memorial Healthcare (Marysville)
  • Fredonia Regional Hospital
  • Hodgeman County Health Center (Jetmore)
  • Morris County Hospital (Council Grove)
  • Nemaha Valley Community Hospital (Seneca)
  • Patterson Health Center (Anthony)
  • Rooks County Health Center (Plainville)
  • Sabetha Community Hospital

Louisiana

  • Ochsner St. Anne Hospital (Raceland)

Massachusetts

  • Fairview Hospital (Great Barrington)

Maine

  • Stephens Memorial Hospital (Norway)

Minnesota

  • Avera Granite Falls Health Center
  • CentraCare – Redwood Hospital (Redwood Falls)
  • Kittson Healthcare (Hallock)
  • Lake View Hospital (Two Harbors)
  • Mayo Clinic Health System – St. James
  • Mayo Clinic Health System – Waseca
  • Meeker County Memorial Hospital (Litchfield)
  • New Ulm Medical Center (New Ulm)
  • Olivia Hospital & Clinic
  • Pipestone County Medical Center & Family Clinic Avera (Pipestone)
  • Riverwood Healthcare Center (Aitkin)

Missouri

  • Carroll County Memorial Hospital (Carrollton)
  • Community Hospital Fairfax
  • Cox Barton County Hospital (Lamar)
  • Pike County Memorial Hospital (Louisiana)

Montana

  • Barrett Hospital & HealthCare (Dillon)
  • Bitterroot Health – Daly Hospital (Hamilton)
  • Central Montana Medical Center (Lewistown)
  • Community Hospital of Anaconda

North Dakota

  • CHI Mercy Health of Valley City
  • CHI St. Alexius Health Carrington Medical Center
  • Jamestown Regional Medical Center
  • Langdon Prairie Health
  • Sanford Mayville Medical Center
  • South Central Health (Wishek)
  • Towner County Medical Center (Cando)

Nebraska

  • Antelope Memorial Hospital (Neligh)
  • Avera St. Anthony’s Hospital (O’Neill)
  • Beatrice Community Hospital & Health Center
  • Boone County Health Center (Albion)
  • Brodstone Healthcare (Superior)
  • CHI Health St. Mary’s (Nebraska City)
  • Community Medical Center (Falls City)
  • Crete Area Medical Center
  • Howard County Medical Center (Saint Paul)
  • Jefferson Community Health & Life (Fairbury)
  • Johnson County Hospital (Tecumseh)
  • Melham Medical Center (Broken Bow)
  • Memorial Health Care Systems (Seward)
  • Phelps Memorial Health Center (Holdrege)
  • Thayer County Health Services (Hebron)

Oklahoma

  • Mercy Hospital Watonga

Oregon

  • Grande Ronde Hospital
  • St. Charles Prineville

South Dakota

  • Avera Hand County Memorial Hospital (Miller)
  • Hans P. Peterson Memorial Hospital (Philip)
  • Madison Regional Health

Texas

  • Lavaca Medical Center (Hallettsville)
  • Moore County Hospital District (Dumas)
  • Olney Hamilton Hospital
  • Reeves Regional Health (Pecos)

Utah

  • Central Valley Medical Center (Nephi)
  • Garfield Memorial Hospital (Panguitch)

Virginia

  • Page Memorial Hospital (Luray)

Wisconsin

  • Black River Memorial Hospital (Black River Falls)
  • Mayo Clinic Health System – Red Cedar (Menomonie)
  • Memorial Hospital of Lafayette County (Darlington)
  • River Falls Area Hospital
  • ThedaCare Medical Center – Shawano
  • Upland Hills Health (Dodgeville)
  • Western Wisconsin Health (Baldwin)
  • Westfields Hospital & Clinic (New Richmond)

West Virginia

  • Grant Memorial Hospital (Petersburg)
  • Hampshire Memorial Hospital (Romney)

Wyoming

  • North Big Horn Hospital (Lovell)
  • Star Valley Health (Afton)
  • Washakie Medical Center (Worland)

Updated CMS Payment for Medicare Part B Preventive Vaccines & Their Administration for Rural Health Clinics & Federally Qualified Health Centers

The Centers for Medicare & Medicaid Services (CMS) released updated information on vaccine payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Effective January 1, 2025, CMS Hepatitis B vaccines are paid like other Part B preventive vaccines. New claim-based payments for Part B preventive vaccines and their administration are effective July 1, 2025. RHCs and FQHCs will need to annually reconcile payments with the facilities’ actual vaccine and vaccine administration costs on their cost reports. Get more information from CMS.gov.

Health Clinics Grapple with US Funding Squeeze

President Donald Trump’s executive orders have begun to disrupt patient care in the United States, as some providers cannot access essential federal funding, according to interviews with a dozen healthcare providers and policy advocates. Facilities in Virginia and West Virginia told Reuters they were forced to shutter primary care clinics or lay off staff. Other community health clinics in California and Virginia said they received notices of termination for federal grants that support HIV prevention care. Source-Reuters

Medicaid Data Dashboard and Reports Released

With Medicaid and CHIP Enrollment at more than 79 million people nationally, data shows the wide range of services accessed by consumers ranging from preventative care to hospital stays and prescription drugs. Medicaid pays for half of all U.S. births and is the largest payer of long-term care and behavioral health services. Pennsylvania has over three million enrollees with more than 750,000 due to Medicaid expansion. Access the Department of Human Services Data Dashboard and Reports for more information.

Rural Provider Participation in Medicare ACOs Grows

The Centers for Medicare & Medicaid Services (CMS) Shared Savings Program Fast Facts updates data on provider and beneficiary participation in an accountable care organization (ACO). An ACO is a group of healthcare providers that work together to coordinate care for Medicare patients. As of January 2025, 53.4% of beneficiaries in Traditional Medicare are enrolled in an accountable care relationship with a provider participating in the Medicare Shared Savings Program (MSSP) and the Center for Medicare and Medicaid Innovation (Innovation Center) accountable care models. In MSSP, the number of rural and safety net providers has grown since last year. There are now 2,872 Rural Health Clinics, 547 Critical Access Hospitals, and 7,036 Federally Qualified Health Centers participating.