The top 10 rural hospitals nationwide, by margin

Rural hospitals are often the most vulnerable to economic pressures, but there is no shortage of success stories for leaders to learn from and emulate, according to the Center for Healthcare Quality and Payment Reform

Those listed here have the best total margins over the last three years, according to information from CMS. Data from 2020 was excluded from the calculations because of unusual cost and revenue changes at the pandemic's outset.

Three-year total margin figures were determined by subtracting cumulative costs from cumulative revenues over the given period, and then dividing the result by the same cumulative cost figure. This is different from the standard for-profit business approach of using revenues in the denominator.

That method assumes a business is trying to keep its costs below prices that are set by the market. Rural hospitals, however, deal with costs that depend on what services are needed, and they depend on payments set at amounts large enough to cover those costs.

 The 10 rural hospitals with the best margins nationwide:

RankHospitalLocationNo. of bedsTotal 2021 expense3 year margin on patient services
3 year total margin
1 Eastern New Mexico Medical Center Roswell N.M. 149 $38.2M 53.3% 131.6%
2 Mercy Hospital Logan County Guthrie Okla. 25 $17.9M 100.3% 115.7%
3 Mercy Hospital Ardmore Ardmore Okla. 175 $138M 115.9% 113.4%
4 Reeves County Hospital District Pecos Texas 25 $38.3M -47.4% 109.1%
5 Uvalde Memorial Hospital Uvalde Texas 25 $48.6M 14.6% 96.7%
6 Garnet Health Medical Center-Catskills Callicoon N.Y. 15 $5.2M -10% 93.8%
7 Western Arizona Regional Medical Center Bullhead City Ariz. 139 $50.9M 18% 86.1%
8 Optim Medical Center-Tattnall Reidsville Ga. 25 $58.5M 71.3% 79.8%
9 CHI St. Alexius Health Devils Lake Devils Lake N.D. 25 $23.6M 27.4% 77.1%
10 Mountain West Medical Center Tooele Utah 44 $53.9M 70.3% 64.6%

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