Critical Access Hospital

A federally designated rural hospital that receives cost-based Medicare reimbursement to preserve essential health services in areas where standard payment rates would make operations financially nonviable. CAH designation requires meeting specific criteria including location, bed count, and average length of stay. Oklahoma has 39 critical access hospitals. CAHs represent the most vulnerable tier of rural health infrastructure. H.R. 1's Medicaid restructuring is projected to create $5.13 billion in losses for Oklahoma's rural hospitals over a decade, and 22 Oklahoma hospitals are at immediate risk of closure. The RHTP's Provider Collaborative Network initiative ($43.1 million) and Rural Regional Reorientation Plan ($26.4 million) are directly aimed at stabilizing CAHs by reducing administrative costs and helping facilities right-size services. As CAHs rationalize their service lines, telehealth — including Portal-based community access — becomes an essential substitute for services that can no longer be provided in-person locally.