Rural Hospitals (Flex Program)


Community Impact and Benefit Activities of CAHs, Other Rural, and Urban Hospitals, 2018

Document Type


Publication Date



rural, hospitals, CAH, critical access hospital, data, benchmarking

Funding Organization or Grant

Federal Office of Rural Health Policy


The Flex Monitoring Team has released a new report on the community impact and benefit activities of Critical Access Hospitals (CAHs), rural non-CAHs, and urban hospitals. The report enables State Flex Programs and CAH administrators to compare the community impact and benefit profiles of CAHs nationally to the performance of CAHs in their state. Pages 1–5 provide national data with key findings and pages 6–95 provide state-specific tables.

Key Findings:

  • CAHs were less likely than other rural and urban hospitals to provide certain community benefit and essential healthcare services (e.g., community outreach, enrollment assistance services, health fairs, community health education, health screenings, health research, indigent care, substance use treatment, psychiatric services, hospice care, palliative care, dental services, hemodialysis, and obstetrics).
  • CAHs were more likely than other rural and urban hospitals to offer adult day care, ambulance services, and long-term care services.
  • CAHs reported higher rates of non-Medicare and non-reimbursable Medicare bad debt and higher unreimbursed costs of Medicaid, CHIP, and state/local indigent care programs than other rural and urban hospitals.

FMI: contact Zach Croll,