Minnesota Department of Health - Office of Rural Health and Primary Care


United States

Top Flex Activities

CAH Quality Improvement

Minnesota’s 77 critical access hospitals (CAHs) have a strong history of public reporting, although it has been observed that reporting is not always consistent. In order to support Minnesota’s CAHs with consistent and accurate reporting, Stratis Health provides ongoing technical assistance on quality reporting, understanding quality data and quality improvement for inpatient, outpatient and EDTC measures. The Minnesota Hospital Association supports Minnesota CAHs with HCAHPS and additional care transitions measures implementing roadmaps to improve medication reconciliation, 30-day readmission rates and health equity.

CAH Operational and Financial Improvement

The Minnesota Flex Program has several initiatives that are designed to provide opportunities for CAHs to better understand their market position and strategize for future success. The Flex program provides an annual charge comparison benchmark report that ensures appropriate pricing levels to provide CAHs with relevant and timely data resources. Future projects will be aimed at specific strategic planning with a cohort of CAHs yet to be determined. Data reduce the leaders' need to gauge performance by precedent which can overlook improvement areas or leave operations under-resourced. Minnesota also plans assessments value-based purchasing or alternative payment model engagement, including the development of a roadmap to guide CAH leaders with steps needed for engaging in new payment models.

CAH Population Health Improvement 

The Minnesota Flex Program is working with subcontractors who will be working closely with cohorts of CAHs on population health improvement in their communities over the next five years. The Minnesota Path to Value cohort is a targeted group of 4 CAHs that are in their third year of designing a care coordination program. The second cohort focuses on coalition building, strategic planning readiness, and capacity building within their organization.

Rural Emergency Medical Services (EMS) Improvement 

The Minnesota Flex Program is working with subcontractors on a qualitative data project to assess the current needs of rural EMS services. These statewide needs assessments are being conducted to provide an updated landscape of resource availability and gaps to better assist in planning and program efforts.

Please provide information about network activities in your state to support Flex Program activities.

The Minnesota Flex Program encourages cohorts of hospitals to work together in projects such as those highlighted above. However, because most CAHs are part of hospital systems or have historically established, well-run networks, the Minnesota Flex Program participation in network development or maintenance is not a high priority. 

Program Statistics

Do you have any hospitals interested in converting to CAH status?:
Type of Organization State Government
Staffing (FTE) Not provided

Organization Website

Number of CAHs 77


Organization Contacts

Tim Held

Rural Health System Development Unit Supervisor/Deputy Director, Minnesota
(651) 201-3868

Specialty Areas / Background

Trauma system coordination

Zora Radosevich

Flex Director, Minnesota
(651) 201-3859

 Flex Director since April 2018

Emma Distel

Flex Coordinator, Minnesota
(651) 201-3528

Flex Coordinator since November 2018