Key Rural Hospital and Clinic Finance Tools and Resources

Small Rural Hospital and Clinic Finance 101

Updated June 2020, this manual was developed for use by state Medicare Rural Hospital Flexibility (Flex) Program personnel as well as small rural hospital and clinic staff/boards. The content is designed to be non-technical, and provide answers to frequently asked questions regarding critical access hospital, small rural hospital, and rural health clinic finance and financial performance. Example topics include:

  • Government Health Care Reimbursement
  • CAH Finances
  • Improving CAH Financial Performance
  • Prospective Payment System (PPS) Finances
  • RHC Finances

340B Drug Pricing Guide

This guide was designed to provide rural hospital leadership with information regarding the 340B Drug Pricing Program. It is also designed to assist State Office of Rural Health directors and Flex Program coordinators to better understand the process hospitals must follow to participate in the 340B Program.

Best Practice Concepts in Revenue Cycle Management Guide

Updated in 2019, this guide provides rural hospital executive and management teams with generally accepted best practice concepts in revenue cycle management so that they may consider opportunities for performance improvement within their hospitals and individual departments. It is also designed to assist State Office of Rural Health directors and Flex Program coordinators in gaining a better understanding of revenue cycle best practices so that they may develop educational trainings to further assist rural hospitals with performance improvement.

Sliding Fee Scale Discount Guide for CAHs and RHCs

This guide provides critical access hospital and rural health clinic executive and management teams with concepts and guidance in developing a Sliding Fee Scale Discount Program. It provides an understanding of how sliding fee scale discount programs relate to Internal Revenue Code Section 501(r) compliance, and participation in the National Health Service Corps (NHSC). Additional content includes:

  • Reasons to implement a sliding fee scale discount program
  • Setting policies
  • Creating a sliding fee scale discount structure
  • Using a sliding fee scale discount in your organization
  • Sliding fee schedule

Telepharmacy Rules and Statutes: A 3-Year Update for all 50 States

A new rural policy brief is available from the RUPRI Center for Rural Health Policy Analysis:

Telepharmacy Rules and Statutes: A 3-Year Update for all 50 States

Jason Semprini, MPP; Fred Ullrich, BA; Keith Mueller, PhD

This policy brief analyzed administrative rules and legislative statutes governing each state’s pharmacy practice. Key features of telepharmacy regulations were investigated for comparative analysis. Twenty-one states currently authorize retail telepharmacy, but between these states the regulatory activity varies considerably.

Please click here to read the brief.

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Five Things About Nursing Homes During COVID-19

July 9, 2020

Today, the Centers for Medicare and Medicaid Services (CMS) is sharing “Five Things About Nursing Homes During COVID-19,” part of an ongoing series by the U.S. Department of Health and Human Services. Safeguarding the health and well-being of the most vulnerable and fragile Americans is a top priority for the Trump Administration. Watch to hear from Administrator Seema Verma about 5 things CMS is doing to stop the spread of coronavirus in nursing homes.

HHS Awards More Than $21 Million to Support Health Centers’ COVID-19 Response

July 9, 2020

Today, HHS awarded more than $21 million to support health centers’ COVID-19 response efforts. The majority of this investment—$17 million—supports 78 Health Center Program look-alikes (LALs) with funding to expand capacity for COVID-19 testing.

With this funding, LALs will expand the range of testing and testing-related activities to best address the needs of their communities, including the purchase of personal protective equipment; training for staff; outreach, procurement, and administration of tests; laboratory services; notifying identified contacts of infected health center patients of their exposure to COVID-19; and the expansion of walk-up or drive-up testing capabilities.

HRSA also awarded over $4.5 million to support the COVID-19 response of Health Center Controlled Networks (HCCNs). HCCNs support health centers to improve quality of care and patient safety by using health information technology to reduce costs and improve care coordination. The funding will strengthen health IT support necessary for participating health centers to effectively prevent, prepare for, and respond to COVID-19.

HRSA’s Bureau of Primary Health Care and Office of Federal Assistance Management will host a Fiscal and Grants Management Orientation webinar for recipients of the Look-Alikes: Expanding Capacity for Coronavirus Testing (LAL ECT) funding. The webinar will highlight key fiscal and grants management requirements with strategies to ensure compliance and properly manage the LAL ECT award.

LAL ECT Fiscal and Grants Management Webinar
Wednesday, July 15
2:30-4:00 p.m. ET
Join the webinar the day of the session
Call-in: 888-566-7701
Passcode: 9747226
Submit questions ahead of time to
Visit the LAL ECT technical assistance page to access resources for award recipients.

Federal Office of Rural Health Policy Announcement

July 9, 2020

HRSA Makes Awards for the Rural Health Network Development Planning Program.  The Health Resources and Services Administration (HRSA) awarded $2 million for this one-year, community-driven program designed to assist in the planning and development of an integrated health care network at the local level. By emphasizing the role of networks, the program creates a platform for medical care providers, social service providers, and community organizations to coalesce key elements of a rural health care delivery system to improve local capacity and coordination of care. Administered by the Federal Office of Rural Health Policy (FORHP) at HRSA, the Network Planning program is an opportunity for rural health care and social service providers to implement new and innovative approaches to care that may in turn serve as a model for other rural communities. Visit the Rural Health Information Hub online to learn more about successful program models and evidence-based toolkits that have come from the work of FORHP-funded projects.

Request for Information: Seeking Stakeholder Input on Scientific Gaps and Research Needs Related to Delivery of Cancer-related Care via Telehealth – July 30.  The National Cancer Institute is seeking information on scientific gaps and research needs related to the delivery of cancer-related care via telehealth. This request for information is part of a planning effort designed to identify promising opportunities and set priorities for research in this area.

NIH Request for Information: Clinical Experience in Suicide Prevention in Primary Care Settings – August 7.  The National Institutes of Health (NIH) seeks information from the public to better understand the opportunities and barriers in the primary care community regarding efforts to care for individuals with suicide risk. Relevant topics include how suicide screening is deployed, cultural/linguistic needs of patients, reaching disparity populations, and telehealth adaptations.

How One Hospital Transitioned a HRSA-Funded Program to Address COVID-19A new feature article in The Rural Monitor profiles a Pennsylvania hospital that credits its previous award of the HRSA Outreach Program grant for 2015-2018 for their quick transition from in-person visits to telehealth under quarantine. Butler Memorial Hospital received the grant from the Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy for a three-year program to help patients access resources for managing chronic disease.

USDA Atlas of Rural and Small-Town America.  The Economic Research Service (ERS) at the U.S. Department of Agriculture (USDA) has updated its atlas to include county population estimates and annual unemployment/employment data for 2019. Researchers at the ERS use data from the U.S. Census Bureau’s American Community Survey, an ongoing function of the Census that keeps track of changes in demographics, employment trends, household incomes, veterans’ status, and other factors that help determine how federal and state funds are distributed.

ONC: Health Information Management at Substance Abuse Treatment Centers.  The Office of the National Coordinator for Health Information Technology (ONC) leads the federal effort to support health information technology systems nationwide. For this report, ONC reviewed a survey conducted in 2017 by the Substance Abuse and Mental Health Services Administration in which 13,585 U.S. substance abuse treatment centers were queried about their use of computers or electronic resources to store and exchange treatment records.

Telehealth Availability in US Hospitals in the Face of the COVID‐19 PandemicThe Journal of Rural Health grants free access to this research policy brief that examines telehealth availability and readiness in U.S. hospitals. The variables examined include organizational factors, county population, geography, and census divisions.

GAO: FCC Needs Comprehensive Strategic Planning for 5G Deployment.  The U.S. Government Accountability Office (GAO) reports that plans by the Federal Communications Commission (FCC) to deploy the next generation of wireless communication technology, called 5G, do not have specific and measurable performance goals and may widen the digital divide for rural areas.

Federal Office of Rural Health Policy FAQs for COVID-19.  A set of Frequently Asked Questions (FAQs) from our grantees and stakeholders, updated regularly.

COVID-19 FAQs and Funding for HRSA Programs Find all funding and frequently asked questions for programs administered by the Health Resources and Services Administration (HRSA).

CDC COVID-19 Updates.  The Centers for Disease Control and Prevention (CDC) provides daily updates and guidance, and ongoing Clinician Outreach and Communication Activity (COCA).

Confirmed COVID-19 Cases, Metropolitan and Nonmetropolitan Counties.  The RUPRI Center for Rural Health Policy Analysis provides up-to-date data and maps on rural and urban confirmed cases throughout the United States. An animated map shows the progression of cases beginning January 21.

Rural Response to Coronavirus Disease 2019.  The Rural Health Information Hub has created a guide to help you learn about activities underway to address COVID-19.