Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
MedPAC Report to the Congress: Medicare and the Health Care Delivery System, June 2025
Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Evaluates Medicare payment issues and provides recommendations to the U.S. Congress. Covers proposed reforms to the physician fee schedule updates and the accuracy of relative payment rates; supplemental benefits in Medicare Advantage; home healthcare use among Medicare Advantage enrollees; Part D prescription drug plans for beneficiaries in fee-for-service Medicare and Medicare Advantage; Medicare beneficiaries in nursing homes; the inclusion of rural providers in current Medicare fee-for-service quality reporting programs; and recommendations related to reducing beneficiary cost sharing for outpatient services at Critical Access Hospitals. Includes rural references throughout.
Additional links: Executive Summary
Date: 06/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Preventing Medical Debt among Rural Residents: Example Programs from Hospitals in Minnesota and Montana
Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Highlights the ways some rural hospitals are working to reduce medical debt for their patients. Presents a number of strategies from hospitals in Minnesota and Montana that aim to reduce patient medical debts through financial assistance programs and cost-cutting measures. Features case-studies reviewing the structure of each hospital's debt reduction efforts.
Author(s): Katie Rydberg, Sushma Shankar, Mariana Tuttle, Carrie Henning-Smith
Date: 06/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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CAH Financial Indicators Report: Summary of Indicator Medians by State
Presents state and national median values of 29 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Presents state and national median values of 29 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Characteristics and Trends of Critical Access Hospitals That Own or Operate Ambulance Services
Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Explores trends in the number of Critical Access Hospital (CAH)-based ambulance services between 2017 and 2022. Analyzes Medicare Cost Report data to compare the characteristics of of CAHs that own and operate ambulance services to CAHs that do not. Presents findings from interviews with eight CAH-based ambulance services regarding the challenges of operating these services, including workforce recruitment and retention issues, the role of partnerships and community involvement, and lessons learned.
Author(s): John Gale, Karen Pearson, Rebecca Stearns, Zachariah Croll
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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2024 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Presents a high-level summary of key data points from the September-November 2024 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; median swing bed admissions and swing bed length of stay; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Date: 05/2025
Sponsoring organization: Flex Monitoring Team
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 04/2025
Sponsoring organization: Flex Monitoring Team
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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 04/2025
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospitals (CAHs)
Printable map that shows the location of Critical Access Hospitals (CAHs) nationwide by state. Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 04/2025
Sponsoring organization: Rural Health Information Hub
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Printable map that shows the location of Critical Access Hospitals (CAHs) nationwide by state. Data source: data.HRSA.gov, U.S. Department of Health and Human Services
Date: 04/2025
Sponsoring organization: Rural Health Information Hub
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Medicare Learning Network: Hospital Price Transparency
Contains information on federal hospital price transparency regulations and compliance, what patients need to know, and a list of helpful websites.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Contains information on federal hospital price transparency regulations and compliance, what patients need to know, and a list of helpful websites.
Date: 03/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Report to the Congress: Medicare Payment Policy: Skilled Nursing Facility Services: Chapter 6
Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Discusses payment adequacy for skilled nursing facility (SNF) services. Features statistics on SNF care provided by rural hospitals and Critical Access Hospitals (CAHs) via swing beds and Medicare margins for urban, rural, and frontier freestanding SNFs in 2023.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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March 2025 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) March 2025 meeting. Covers research and proposals related to reforming physician fee schedule updates and improving the accuracy of relative payment rates, reducing beneficiary cost-sharing for outpatient services at Critical Access Hospitals, Medicare insurance agents, Medigap, payment for ground ambulance services, home healthcare use among Medicare Advantage enrollees, and institutional special needs plans. Includes rural references and considerations throughout.
Additional links: Mandated Report: Payment for Ground Ambulance Services, Reducing Beneficiary Cost-Sharing for Outpatient Services at Critical Access Hospitals
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Last Updated: 6/12/2025