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Medicare Rural Hospital Flexibility Program (Flex)

We fund the Flex program to help Critical Access Hospitals (CAHs), emergency medical service (EMS), clinics, and health professionals work together. This increases quality of care.

Flex also improves hospital-based healthcare access for rural communities.

Who carries out Flex?

State Offices of Rural Health (SORH) carry out the Flex program. The Flex program serves 1,353 CAHs across the United States.

How does Flex help CAHs?

The Flex program funds states to provide technical assistance for CAHs.

How do Flex funds support CAHs?

To improve:

  • Rural health care quality
  • Financial health and hospital operations
  • Emergency medical services
  • Health of people who live in rural areas

Do all states offer the same technical assistance?

No. States look at what hospitals need. They tailor technical assistance based on those needs.

How can my hospital qualify for Flex?

To qualify for the Flex program, your hospital must be a Critical Access Hospital (CAH) (PDF - 935 KB). CAH is a designation from Medicare. Flex supports hospitals that Medicare designates as a CAH.

How can my hospital apply for Flex?

Contact your State Office of Rural Health. HRSA Exit Disclaimer They can let you know if you qualify, answer questions, and help you apply.

How have Critical Access Hospitals (CAHs) improved in 2020?

  • Nearly 100% voluntarily reported quality measures through the Medicare Beneficiary Quality Improvement Project.
  • Almost 75% improved after taking part in quality improvement activities.
  • Over 40% improved on a financial measure after taking part in financial improvement activities.

Contact Us

I’m a State Office of Rural Health (SORH)...
Contact our Flex Program Coordinator
Victoria Leach
Email: VLeach@hrsa.gov
Phone: 301-945-3988

I’m a rural hospital...
Contact the Project Officer in your state.

Date Last Reviewed:  November 2021