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© 2014 Elsevier B.V. We show that the full version of the so-called 'rural hospital theorem' generalizes to many-to-many matching problems where agents on both sides of the problem have substitutable and weakly separable preferences. We reinforce our result by showing that when agents' preferences satisfy substitutability, the domain of weakly separable preferences is also maximal for the rural hospital theorem to hold. ; F. Klijn gratefully acknowledges financial support from the Barcelona Graduate School of Economics, the Government of Catalonia (SGR2009-01142), and the Spanish Ministry of Economy and Competitiveness through Plan Nacional I+D+i (ECO2011-29847) and the Severo Ochoa Programme for Centres of Excellence in R&D (SEV-2011-0075) ; Peer Reviewed

JEL–Numbers: C78, D60 ; We show that the full version of the so-called 'rural hospital theorem' (Roth, 1986) generalizes to many-to-many matching where agents on both sides of the market have separable and substitutable preferences. ; Financial support from Plan Nacional I+D+i (ECO2008–04784), the Consolider-Ingenio 2010 (CSD2006–00016) program, the Barcelona Graduate School of Economics and the Government of Catalonia (SGR2009–01142) is gratefully acknowledged. The first draft of this paper was written while the author was visiting Universidad del Rosario, Bogot´a (Colombia). He gratefully acknowledges the hospitality of Universidad del Rosario and a research fellowship from CSIC. ; Peer reviewed

Examines state policies to assist rural hospitals experiencing severe financial stress; US.

Begun as an egalitarian crusade of the Truman administration in 1946 to create a loose network of small hospitals for populations across the country's remote regions, the rural hospital movement has never faced threats to its existence as dire as those confronting it today. And that situation continues to worsen as fragmented—and often contradictory—federal and […]

Because the Balanced Budget Act (BBA) of 1997 requires implementation of a Medicare prospective payment system (PPS) for hospital outpatient services, the authors evaluated the potential impact of outpatient PPS on rural hospitals. Areas examined include: (1) How dependent are rural hospitals on outpatient revenue? (2) Are they more likely than urban hospitals to be vulnerable to payment reform? (3) What types of rural hospitals will be most vulnerable to reform? Using Medicare cost report data, the authors found that small size and government ownership are more common among rural than urban hospitals and are the most important determinants of vulnerability to payment reform.