ArticleHealth affairs (Project Hope)2025
Mixed Evidence That Rural Hospitals' Finances Improved With Participation In The Pennsylvania Rural Health Model.
Article in Health affairs (Project Hope), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Cancer Surgery Outcomes After Implementation of a Global Budget Model in Rural Hospitals.Annals of surgery · 2026Article
- Mandatory Value-Based Payment Programs and Hospital Administrative Costs.JAMA health forum · 2026Article
- Impacts of a Rural Hospital Global Budget Alternative Payment Model on Patterns of Cancer Surgery.Medical care · 2026Article
- Payer mix shifts and profitability at critical access hospitals, 2011 to 2023.Health affairs scholar · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
The voluntary Pennsylvania Rural Health Model (PARHM) provided participating rural hospitals with global budgets rather than traditional fee-for-service payments to improve financial stability. Whether participation in PARHM was associated with financial improvements is unknown. In this synthetic difference-in-differences study from the period 2014-23, we estimated changes in rural hospital finances associated with PARHM participation among seventeen PARHM participants and forty nonparticipating Pennsylvania comparison hospitals. In unadjusted models, participation was associated with a 4.5-percentage-point differential increase in operating margins and a 4.7-percentage-point differential increase in total margins; however, these changes were nonsignificant in adjusted models (3.0 and 3.2 percentage points, respectively). Results were similar when we compared PARHM participants with 160 border-state comparison hospitals and when we used alternative difference-in-differences estimators. These findings offer mixed evidence that global budgets may help stabilize rural hospital finances in the short term.
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Registered trials
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