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All Hat, No Cattle: When Urban Hospitals Pretend to be Rural

Why would a large urban hospital want to be considered rural?

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Newt Gingrich
Aug 25, 2026
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You’ve probably heard the expression, “all hat, no cattle.” It describes someone who wears trappings of a cowboy but has never stepped foot on a ranch.

Well, the phrase also applies to some urban hospitals.

A Health Affairs study found that the number of geographically urban hospitals benefiting from a federal program intended to support those in rural co…

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