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State Flex Programs must understand QI principles, resources, and trends to support CAHs in advancing QI.
The Flex Program and CAH designation was established and remains in place because of the financial vulnerability of small rural hospitals. CAH financial and operational improvement is one of the required program areas of the Flex Program.
State Flex Programs can help CAHs transition into value-based systems, population health models, and future opportunities through education, network support, facilitation of new partnerships, and technical assistance.
It is important for state Flex Programs to understand the community needs of CAH and RHC service areas to develop or leverage program activities in support of health system development, community engagement, and population health improvement.
The Flex Program Forum is for content related to the Medicare Rural Hospital Flexibility (Flex) Program and rural health care.
There are many measurable and nonmeasurable benefits to participation in the RHPTP program.
Organizations selected to participate in the Rural Healthcare Provider Transition Project (RHPTP) should exhibit strong leadership and a commitment to fully engage in project consultations and activities that prepare them for population health and value-based care through alternative payment models.
Announcing the 2025-2026 selected organizations!
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.
Managing the cooperative agreement is one of the primary responsibilities of state Flex Programs and includes: budgeting, cooperative agreement application writing, working with partners, information management, and reporting.
Answers to commonly asked questions about the Delta Region Community Health Systems Development (DRCHSD) Program including eligibility, benefits of participation, the application process, community care coordination, and more.
Guides to provide a brief overview and links to key documents to help rural health care professionals, practices and hospitals understand the billing code, consider the benefit to their patients and organization and begin billing for the code.
Developed specifically for rural organizations, this assessment is designed to provide a preliminary review of critical factors for organizations looking to develop, expand or enhance care coordination efforts.
Learn transition strategies from the 2017 Rural Hospital Value-based Strategic Summit with strategy map and balanced scorecard templates.
Learn efficiency and effectiveness of revenue and expense management, service line analysis and development, APMs and relationships with other health care providers in the provision of health care services.
Browse the FAQ regarding RHPTP's application, eligibility, selection, and technical assistance.