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Allowable Investments

Small Rural Hospital Improvement Program allowable investments include activities that assist small rural hospitals with their value and quality improvement efforts and adaptation to changing payment systems through investments in hardware, software, and related training.

Care Management and Coordination

Effective care management is key in achieving the aims of health care transformation and the journey down the road to value-based care. Care management leads to healthier people because they are connected to the needed resources and community services. Quality of care improves when patients are connected to the right services at the right time through care management. Due to the right services and the right care, care management leads to wiser spending.  The following are resources that will help with development or improvement of care management and coordination.


More and more organizations recognize that moving toward population health and addressing the complex issues seen within rural health care call for collaboration with diverse sets of partners and stakeholders. The National Rural Health Resource Center believes in the strength of developing partnerships and collaboratives to create synergy among rural health organizations and to improve the health of rural communities.


Community Champion Toolkit

This Community Champion Toolkit is to be used by selected health care organization Community Champions and their supervisors as they step through the program. Each toolkit page contains key tools to help build Community Champion skill sets that enhance their role in community health planning and supports ongoing educational training. 


Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death by disease in the United States. The percentage of adults in rural areas who have been diagnosed with COPD is nearly double the percentage in large metropolitan areas.

Core Competencies for State Flex Program Excellence

This 2022 Guide offers anyone who manages and/or works on the Medicare Rural Hospital Flexibility (Flex) Program the opportunity to complete a competency self-assessment, identify areas of proficiency, recognize opportunities for improvement and development, and to use the Guide to understand and gather insight into what determines proficiency and how it can be developed. Tips, tools, and resources are also included in the Guide to provide additional background and support.


In response to the Coronavirus (COVID-19) Pandemic, the National Rural Health Resource Center (The Center) continues to strive in providing the most up-to-date and relevant tools and resources for rural clinics, hospitals, and their communities.

    Customizable Communications Toolkit

    The Customizable Communications Toolkit is designed to support the communication needs of rural hospitals and clinics that are seeking to promote health care confidence, along with specific organizational programs and services.

    Emergency Medical Service (EMS)

    This collection of resources is intended to help rural EMS services adapt to and become a more integrated part of the evolving health care system.