Hospitals and health systems have navigated through various challenges throughout the pandemic, but staffing is expected to remain top of the agenda for hospital executives over the coming years.

Rural hospitals face a myriad of economic and financial pressures. Here are the 50 rural hospitals with the best margins, according to data from the Center for Healthcare Quality and Payment Reform: 

Economic activity, driven mainly by greater inpatient volumes linked to the tripledemic of RSV, flu and COVID-19, grew in December for the 31st straight month in the hospital subsector, the Institute for Supply Management said Jan. 9.

The outlook for Mullica Hill, N.J.-based Inspira Health was revised to stable from positive amid its "adequate" financial profile, Moody's said Jan 6.

Forty-two percent of revenue cycle leaders said claims denials are increasing, according to a recent report from Experian Health.

Ten hospitals or health systems recently posted job listings seeking revenue cycle management expertise.

Toledo, Ohio-based ProMedica Health has had its rating removed from a negative credit watch imposed in August 2022 and remains overall "BB" rated by S&P Global.

Boise, Idaho-based St. Luke's Health System saw its income for 2022 vastly reduced amid higher operating expenses and losses on its investment values, leading to a fall in its overall worth.

Rural hospitals are under immense financial strain. Since 2005, 183 rural hospitals have closed. 

Margins will eventually rebuild to historic levels and a strong management team will help ensure so, Moody's said of MedStar Health as the rating agency affirmed an "A2" credit rating with a stable outlook for the Columbia, Md.-based healthcare system.