Rural hospitals are navigating one of the most difficult financial environments in recent memory.

Declining patient volumes, lower Medicare and Medicaid reimbursement, staffing shortages and rising regulatory demands are squeezing already-thin margins. Recent changes to Medicaid eligibility requirements and the expiration of enhanced Affordable Care Act premium tax credits are expected to strip an additional $1.6 billion in revenue from rural hospitals nationally1, compounding pressure that was already mounting.

“While much of this pressure is outside any single hospital’s control, finance teams do have a lever they can manage: revenue integrity,” says Beth Kim, Vice President of Revenue Integrity of CHC. “Today it is critical that hospitals are capturing every dollar earned. That is the discipline of revenue integrity, and for rural and community hospitals, it is increasingly a financial lifeline.”

Here is a look inside revenue integrity: what it protects, why it matters and a look at the three-step revenue integrity strategy from CHC.

Read more from CHC’s Beth Kim, VP of Revenue Integrity, in this HealthLeaders’ article, October 15, 2026.