Resources

This Medicare Rural Hospital Flexibility (Flex) Performance Management and Evaluation Guide aims to support Flex Program Coordinators towards incorporating performance management into program operations, leading towards program improvement and evaluation.

The guide for state Flex Programs contains relevant and practical recommendations and tools to strengthen staff engagement and retention through the Staff Sustainability Cycle described within, which consists of recruiting, onboarding, learning and development, engagement and retention, and succession planning.

The Pulmonary Rehabilitation Campaign — with messages tied to the themes of “From Winded to Wonderful,” “Breathing is Easy. Until it’s Not.” and “Breathe Relief Into Your Life” — is designed to educate health care consumers and providers about services that can be easily accessed locally.

This guide provides information about the current status and history of the 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.

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

This list includes quality improvement resources that can be used across a variety of project topic areas.

These resources provide information about how to submit Medicare Beneficiary Quality Improvement Project (MBQIP) data and how to interpret data reports in order to inform quality improvement efforts.

These resources focus on quality improvement for care transitions.

These resources focus on quality improvement for outpatient hospital services, primarily those provided in the emergency department (ED).

These resources focus on quality improvement related to the patient experience.

These resources focus on quality improvement related to patient safety and inpatient care.

The National Rural Health Resource Center (The Center) has launched the 2025 update to its Population Health Toolkit, which is designed to assist State Offices of Rural Health, state Medicare Rural Hospital Flexibility (Flex) Programs and individual health care organizations as they seek to better understand, manage and improve population health in their communities and states.

America’s rural health care system faces growing challenges in accessing capital funding for essential infrastructure projects. This paper provides a historical overview of major capital funding programs and analyzes the persistent challenges that prevent rural health care providers from converting available funding into usable capital—undermining sustainability in rural health systems.

View a list of key resources curated by the Technical Assistance and Services Center (TASC) for use by state Flex Programs to support incorporation of performance management into program operations, feeding into program improvement and evaluation

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

A 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.

Resources to support abstracting, submitting, and confirming data submission to the Centers for Medicare and Medicaid Services (CMS) QualityNet Warehouse, including the CMS Abstraction and Reporting Tool (CART) and reporting specifications manuals. 

Flex Program Fundamentals: An Introduction to the Medicare Rural Hospital Flexibility Program is designed to be used by both new and current Flex Program staff: as an orientation manual and as a guide to helpful resources.

Access Flex Program funding guidance, templates, webinar recordings, the Flex Program Structure Document, and other associated materials for the current funding cycle.

Customer engagement is an important outcome of an overall learning and performance excellence strategy. Use these resources to learn more about identifying population health partners.