Federal Flex Updates: May 2017

May 2017

Thank you for all of the hard work you put in writing your non-competing continuation (NCC) reports. Your project officers are starting to review them now and we will be reaching out if we have questions.

On Thursday, June 1, 2017, we will have a webinar about supplemental Flex funding for fiscal year (FY) 2017. Due to the enactment of final FY 2017 appropriations on May 5, 2017, this supplemental funding opportunity will have tight timelines. Please join the webinar and be prepared to act promptly on the supplemental funding request if it makes sense for your state. Watch for an email for more information and post questions in the Flex Forum.

Everyone has seen the Performance Improvement and Measurement System (PIMS) Data Collection Tool, developed by Caleb Siem of the National Rural Health Resource Center and Technical Assistance and Services Center (TASC) and me with lots of help from John Gale and Andy Coburn of the Flex Monitoring Team and a stakeholder group of Flex Coordinators. We designed this tool to make your PIMS data collection and reporting easier by collecting data all year long as you plan and implement projects, instead of trying to collect all of the data for PIMS at the end of the budget year. The PIMS Data Collection Tool and a recorded walk-through webinar are available together on the TASC website.

In addition to making it easier for you to report PIMS, the tool and consistent critical access hospital (CAH) tracking will also help make PIMS data more valid and reliable across the 45 Flex states. As you saw on the PIMS Data Update webinar in January, we observed some inconsistencies in the data reported in PIMS for FY 2015. I expected such variation in the first year since this was a new and unfamiliar report format for everyone. Now we have the opportunity to practice continuous quality improvement within the Flex Program itself and make this data more valid and reliable in the next reports. We use PIMS data in our annual Flex Program performance measures reported to the Health Resources and Service Administration (HRSA) leadership and, ultimately, the Secretary and Congress. We also use PIMS data to inform internal Flex Program development. 

For the next step in ongoing Flex development, we are now working on planning future Flex Program direction for the next project period, which, pending availability of funds, would begin September 2018. While future funding is not guaranteed, we want to be proactive in ensuring that the Flex Program aligns with the realities of CAHs providing care in this changing environment, does not duplicate or conflict with other initiatives and aligns with the program statute.

Your input based on your expertise and insights from your work and the work of your CAHs is key to successfully aligning the Flex Program to meet rural needs. Additionally, I don’t expect major changes in the focus of the program—we will continue to emphasize measuring impact and making key improvements in CAH quality, finance, population health and the delivery of emergency medical services (EMS). With this next project period, we are trying to refine each area and allow flexibility at the state-level while improving our ability to measure impact at the national level.

Planning Flex’s future direction will involve a lot of ideas, information sharing and requests for your input. Unavoidably this is in addition to your usual summer work—we will all be busy! Over this spring and summer, you should expect requests for input on a range of issues in the Flex Program. We need input from state Flex Coordinators, your CAHs and other Flex stakeholders. This information gathering started with the request for Flex improvement ideas in the NCC narrative and will continue with invited workgroups and open requests for input in the various program areas of Flex. These include quality improvement and the Medicare Beneficiary Quality Improvement Project (MBQIP), financial and operational improvement, population health improvement, EMS integration and improvement and supporting innovation. As the Flex Team, we are each leading different topics so you will hear from Owmy Bouloute on population health, Christy Edwards on EMS, Yvonne Chow on MBQIP and Sarah Young on finance, innovation and Flex issues overall.

We will have a lot happening, and it could be hard to follow everything. Please reach out to me anytime if you want clarification on anything or if you have an idea that doesn’t fit anywhere else. I am looking forward to learning from your ideas and insights as we develop the future of Flex.

Sarah Young
Flex Program Coordinator

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.