Rural Emergency Hospital
- What is a Rural Emergency Hospital?
Rural Emergency Hospital (REH) is a new payment and service delivery model created by the Consolidated Appropriations Act of 2021. Congress created the REH designation to address the rural hospital closure crisis. The Centers for Medicare & Medicaid Services, the federal agency responsible for REH regulation and oversight, promulgated final rules governing REH operation late in 2022.
- Which hospitals are eligible for the REH designation?
Existing Critical Access Hospitals (CAH) and rural acute care hospitals with 50 or fewer beds open on December 27, 2020, are eligible for the REH designation. Currently, 40 hospitals in Oklahoma carry the CAH designation. Researchers at the North Carolina Rural Health Research Program estimate that 68 rural hospitals nationwide will convert to the REH designation, with four from Oklahoma converting.
- What does the REH designation mean for my hospital and my community?
The REH designation could be a lifeline for some financially struggling hospitals. However, every hospital and community is unique. Thorough due diligence is necessary for any hospital looking to convert to the REH designation. The potential for financial stability and 24-hour access to emergency health services associated with REH status comes with tradeoffs. For example, CMS limits the annual average length of stay per patient to 24 hours or less. Most REH facilities will no longer provide a wide range of traditional inpatient care services to meet this provision. They will also be removed from the 340B drug pricing program. Under current regulations, it is unclear if hospitals with an REH designation can convert back to CAH or Prospective Payment System (PPS) status.
- How Can the Oklahoma Office of Rural Health Help?
The Oklahoma Office of Rural Health can provide technical assistance to hospitals and communities navigating the conversion process. In addition, our YouTube channel archives three REH information webinars we hosted over the past year (see Additional Resources section below). The videos feature content from experts and are geared toward Oklahoma hospitals. For more about the assistance we can provide or for answers to questions not addressed here, please contact the Oklahoma Office of Rural Health at (405) 945-8609, Lara Brooks (lara.brooks@okstate.edu), or Corie Kaiser (corie.kaiser@okstate.edu).
- Additional Resources & Information
Webinars & Presentations
- Rural Emergency Hospital Session 1: Laying the Foundation
- Rural Emergency Hospital Session 2: Impact on Hospitals
- Technical Assistance for Rural Emergency Hospital Consideration
- Orientation to Rural Emergency Hospital Conversion and Technical Assistance
- Orientation to Rural Emergency Hospital Conversion and Technical Assistance, Additional Guidance
Websites
- Rural Emergency Hospital Technical Assistance Center
- Oklahoma Hospital Association
- American Hospital Association
- National Rural Health Association
- Rural Health Information Hub (RHIhub)
Policy Papers & Briefs