The REH designation was created to help sustain access to emergency and outpatient care in rural communities that can no longer support inpatient services. As more hospitals convert, a key question is whether the model is improving financial stability. In this brief, we examine hospital profitability before and after conversion to REH status using Medicare Cost Report data for 32 hospitals. These early results suggest the REH model may offer a more stable financial pathway for some struggling rural hospitals—though findings should be interpreted cautiously, as many post‑conversion reporting periods reflect less than a full year of operations.

An Early Look at Profitability Before and After Conversion to Rural Emergency Hospital
NC Rural Health Research Program, UNC Sheps Center | March 2026