Rural Health Fact Sheets

One in seven Americans live in rural areas and rely on rural hospitals and health systems for the health and well-being of their communities.

Medicare pays most acute care hospitals under the inpatient prospective payment system (IPPS). Some of these hospitals receive additional support from Medicare to help address potential financial challenges associated with being rural, geographically isolated and low volume. These programs are Low-volume Adjustment (LVA)Medicare-dependent Hospitals (MDHs), and Sole Community Hospitals (SCHs).

Rural fact sheets and Hill materials.

The Rural Community Hospital (RCH) demonstration tests an alternative payment model for small rural hospitals, in response to concerns that they face financial difficulties with Medicare’s inpatient prospective payment system (IPPS).

America’s hospitals and health systems continue to deal with the difficult challenges of high inflation and ongoing effects of the COVID-19 pandemic. Specifically, hospitals are facing significant increases in costs of labor from workforce shortages, drugs, equipment and supplies (including food and energy costs) that are threatening their stability and ability to provide access to high quality health care services. The AHA has developed resources that hospital leaders can use to advocate on these important issues.

The AHA urges Congress and the Biden Administration to prioritize funding for the infrastructure that supports rural hospitals and the communities they serve. Key areas of investment include physical infrastructure and “right-sizing,” capacity to enable digital health, workforce support and access to behavioral health services.

Telehealth connects patients to vital health care services through videoconferencing, remote monitoring, electronic consults and wireless communications.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law on March 27, provides resources and flexibility for rural hospitals.

AHA Ask: AHA supports protecting patients from surprise medical bills. Policymakers should focus on assisting rural hospitals in their negotiations with payers and providing the incentives and resources needed to maintain local access to care and not undermine these communities with potentially harmful national policy changes.

The Frontier Community Health Integration Project (FCHIP) Demonstration tests several new models of health care delivery for rural Critical Access Hospitals (CAHs) in the most sparsely populated states.

The Senate Health, Education, Labor and Pensions Committee June 19 introduced the Lower Health Care Costs Act (S.1895), legislation to prevent surprise medical bills, reduce prescription drug prices, improve transparency in health care, invest in public health and improve health information exchange.

The AHA Task Force on Ensuring Access in Vulnerable Communities examined ways in which the access to and delivery of care could be improved. This strategy – focused on cooperation and collaboration through integration of rural hospitals and health clinics – is a way for vulnerable rural areas to better meet community need and stabilize and expand services as those needs change.

Medicare and other federal programs must account for the special circumstances of rural communities.