Navigating the REH Pathway: A Step-by-Step Guide for Rural Hospitals

An overview of the pathway to REH designation, where the Rural Health Redesign Center (RHRC) provides essential support through the Rural Emergency Hospital Technical Assistance Center (REH-TAC).

Introduction

The Rural Emergency Hospital (REH) designation is a significant development in healthcare designed to help rural communities sustain their access to emergency medical services and outpatient care. Through a series of steps, the RHRC provides essential support for hospitals to achieve the REH provider-type designation. The Rural Health Redesign Center (RHRC) provides essential support for hospitals considering the REH designation via the Rural Emergency Hospital Technical Assistance Center (REH-TAC).

Outreach

Hospitals interested in working with the RHRC to assess the REH designation begin by completing an intake form that collects basic organizational information and gauges their understanding of the REH conversion. 

Education

The RHRC team provides educational resources and sets up an introductory call to discuss the hospital’s suitability for conversion. This step is crucial for hospitals to understand REH regulations, assess their current operations, and decide if pursuing the REH status makes sense for them.

Liaison Assignment

Hospitals that opt to proceed are paired with a Provider Liaison from the RHRC team. These liaisons offer one-on-one support and are former rural hospital executives with experience leading rural healthcare organizations through significant change. 

Financial Assessment

A financial assessment process is completed to inform decision-making. Past, current, and future financial indicators are utilized to determine feasibility.

Financial Modeling

The financial modeling stage involves collaborative sessions with the RHRC to customize a formal Financial Model to the hospital’s specific service lines and delivery pathways. This model considers both the current hospital payment and the REH payment structures to guide decision-making. 

The financial modeling stage involves collaborative sessions with the RHRC to customize a formal Financial model to the hospital’s specific service lines, care delivery pathways, and financial projections. Process timelines vary, and there is no obligation to move forward with REH conversion after receiving a financial model.

Application & Transition Planning

The RHRC assists with the application to the Centers for Medicare & Medicaid Services (CMS). The application process requires an attestation, an action plan, and a transfer agreement. The RHRC offers assistance through a multi-modal approach, including one-on-one support from your liaisons and our partners.

Conversion

The final phase involves converting to the REH status, with the RHRC offering ongoing post-conversion technical assistance. This assistance includes compliance, identification of community needs, strategic planning, and more.

Conclusion

The journey to becoming a Rural Emergency Hospital is a structured pathway designed to bolster healthcare access in rural areas. RHRC’s support ensures that hospitals are well-informed and strategically equipped to transition smoothly to the REH provider type. 

Janice Walters
Executive Director
Janice has been leading the work of the RHRC since its inception. She has a background in health finance and is a highly rated rural health expert with over 20 years of relevant leadership experience.