Changing Landscape and Designation Within Rural Healthcare

by Roger Barnhart

The landscape within rural communities was very different in 1977 than it was 20 years later when Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997. The intent was to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. In the 20+ years since, healthcare and the settings in which it is provided (and subsequent regulations) has continued to evolve.