There are 36 Critical Access Hospitals in the State of MI. This includes 11 in the Upper Peninsula of MI, and 25 in the Lower Peninsula.
Background: Critical Access Hospital is a designation given to eligible rural hospitals by the Centers for Medicare & Medicaid Services (CMS). Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997 (Public Law 105-33) in response to over 400 rural hospital closures during the 1980s and early 1990s.
Congress also created The Medicare Rural Hospital Flexibility Program (Flex Program) in 1997 which allows small hospitals to be licensed as Critical Access Hospitals (CAHs) and offers grants to States to help implement initiatives to strengthen the rural health care infrastructure. The Michigan Center for Rural Health implements the Flex Program for the State of Michigan.
To participate in the Flex Program, States are required to develop a rural health care plan that provides for the creation of one or more rural health networks, promotes regionalization of rural health services in the State, and improves the quality of and access to hospital and other health services for rural residents of the State. Consistent with their rural health care plans, states may designate eligible rural hospitals as CAHs.
- List of Michigan CAHs
- The Rural Health Information Hub has a wide variety of resource related to CAHs including information on regulations, benefits of CAH status, and payment methodology.
- This resource from CMS includes basic information about being certified as a Medicare Critical Access Hospital (CAH) provider and includes links to applicable laws, regulations, and compliance information. Updated February 2023 to include the following changes:
- 1.) the critical access hospital (CAH) location relative to other facilities to include areas with only secondary roads available (page 5)
- 2.) CAHs must now inform the patient or their representative of their rights before starting or ending care and establish a grievance process (page 5)
- 3.) A CAH that’s part of a health system with more than 1 hospital or CAH must now have a Quality Assessment and Performance Improvement Program to ensure it meets requirements (page 5)
- 4.) Clarified that under the optional payment method, the CAH bills facility and professional outpatient services only when the physicians or practitioners have reassigned their billing rights to them (page 9)
Quality Improvement
Learn how the MI Flex Program is driving quality improvement in MI CAHs, via the Michigan Critical Access Hospital Quality Network (MICAH QN), and the Medicare Beneficiary Quality Improvement Program (MBQIP).
MI CAH Financial Network
Learn how the MI Flex Program is using data to drive improvement, by providing financial & operational resources to MI CAHs.
National CAH and Rural Hospital Financial Resources
Explore national resources for Critical Access Hospitals and Rural Hospitals.