Examining the Effect of System Affiliation on Critical Access Hospital Financial Performance

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Rural hospital mergers with health systems increased steadily between 2009 and 2014, which prior research has found may have implications for Critical Access Hospital (CAH) financial performance measures in the form of short-term reductions in operating margins and declines in salary expense. In this project, the Flex Monitoring Team will examine whether CAHs affiliated with a health system differ in their financial performance compared to unaffiliated hospitals. The project will also evaluate the feasibility of including an annual analysis of such data in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS).