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State Flex Program Key Resources

This list includes key resources for State Flex Programs implementing and supporting the Medicare Beneficiary Quality Improvement Project (MBQIP).


This guide provides information about the current status and history of MBQIP. It is intended to help state Flex Program personnel, and relevant subcontractors understand the basics of MBQIP, including key resources available to support them in their work. 

Upon request from a state Flex program, the Rural Quality Improvement Technical Assistance Center (RQITA) is available to provide presentations to various audiences regarding topics related to MBQIP and critical access hospital (CAH) quality reporting and improvement. This resource includes a list of some of the topics on which RQITA is available to present as well as a link for requesting a presentation.

MBQIP Monthly is a monthly e-newsletter that provides CAHs with information and support for quality reporting and improvement and highlights current information about MBQIP outpatient.

This chart outlines the current MBQIP measures. Measures are divided into two categories: core and additional. Measures are further divided into four domains: patient safety/inpatient, patient engagement, care transitions, and outpatient.


Federal Office of Rural Health Policy (FORHP)

This document shares anticipated release dates for MBQIP Reports, as well as sharing a list of the most recently released reports.

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Flex Monitoring Team

MBQIP Virtual Knowledge Group (VKG) webinars provide a networking opportunity for state Flex Programs. Topics for discussion are determined based on MBQIP Data Reports, technical assistance trends, and requests.

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MBQIP VKG Webinars (needs a link)

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The MBQIP Measures Fact Sheets provide an overview of the data collection and reporting processes for the MBQIP measures. The goal of this resource is to capture details regarding the MBQIP measures and provide them in a basic, one-measure-per-page overview. The intended audience for these fact sheets is CAH personnel involved with quality improvement and/or reporting and state Flex Program personnel.

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This list of summary statements is intended to equip state Flex program staff with talking points to address concerns and encourage participation in quality reporting and improvement programs.

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View the criteria to be eligible to participate in Flex-related activities for Fiscal Year (FY) 2020. Learn exceptions and answers to frequently asked questions and access the 2019 MBQIP sample waiver template.

An MOU is required in order for any CAH to participate in MBQIP. Access current and past MBQIP MOU and consent forms as well as descriptions of when to use them.

Instructions for state Flex Programs regarding the use of FORHP-provided templates for submission of data for Emergency Department Transfer Communication (EDTC).

These two resources are intended to help state Flex programs use the Excel data files and PDF data reports provided by FORHP on a quarterly basis. The Excel files accompany the PDF data reports and contain MBQIP data, including hospital level denominators and hospital level numerators or medians, as well as hospital submission status and population & sampling data. The Using MBQIP Excel Files guide includes overviews of the various Excel data files, as well as basic instructions for how to manipulate the data files for analysis. The log of updates and changes provides an up-to-date summary of modifications and changes made to the MBQIP data reports and Excel data files since 2016. 

The Antibiotic Stewardship Detailed Data Summarization Tool was created to help state Flex programs summarize and make use of the Core and Detailed Annual Facility Survey antibiotic stewardship data. It provides both a core element summary and a question-by-question summary of CAH responses at both state and hospital levels. 

States can use this information to: 

  • Identify gaps in implementation holding hospitals back from achieving success in implementing the 7 core elements
  • Identify opportunities for enhancing antibiotic stewardship programs in all hospitals
  • Identify hospitals that have successfully implemented various antibiotic stewardship program components to learn from and share with other hospitals 
  • Compare hospital responses to specific questions year over year to confirm consistency in responses. 

Use this Excel template to assist Flex Programs in producing comparison graphs for CAHs for hospital and state Emergency Department Transfer Communication (EDTC) performance. Flex Programs can easily use data from their EDTC submission file to produce graphs for inclusion in presentations or reports for CAHs in their state. The template has been updated to reflect the 2020 changes to the EDTC specifications. There are two templates available for your use (by quarter and by measure).

This Excel template can be used by Flex Programs to produce comparison graphs for CAHs that displays hospital and state performance on Centers for Medicare and Medicaid (CMS) Inpatient (IP) and Outpatient (OP) measures. By using this template, Flex Programs can easily use data from the IP and OP data files received from FORHP each quarter to produce graphs for inclusion in presentations or reports for CAHs in their state. 

This document provides an overview of the CMS Overall Hospital Quality Star Ratings including background information, rural relevant discussion/talking points, and a summary of the methodology including the recent changes made as part of the Calendar Year 2021 CMS Outpatient Prospective Payment System final rule.

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This guide highlights ideas for Flex Programs to foster an informal peer mentoring environment, followed by basic guidance to develop a more intentional and structured peer mentoring program for their CAHs. Sample documents from the formal peer mentoring program in North Dakota are included.


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