Idaho State Flex Profile

Top Flex Activities

Program Area: Support for Quality Improvement: 

The Idaho Flex Program is implementing “Moving the Needle,” an Idaho peer learning collaborative series which provides an opportunity for all 27 Idaho critical access hospitals (CAHs) to participate in quality improvement educational opportunities focused on all required Medicare Beneficiary Quality Improvement Project (MBQIP) measures. The series focuses on providing CAHs with population and sampling criteria, data collection best practices and sharing evidence-based tools and strategies to improve outcomes. It also allows Idaho CAHs to benchmark against their baselines for all required MBQIP measures. Activities include:

  • In-person full-day annual educational workshops in November and May facilitated by a consulting firm
  • Two webinars annually focused on benchmarking facilitated by a consulting firm
  • Onsite technical assistance site visits conducted annually to all 27 CAHs by the Flex Coordinator  
Please share a success story about reporting quality data or using quality data to help Critical Access Hospitals (CAHs) in your state improve patient care: 

All Idaho CAHs are actively participating in MBQIP and all CAHs have received education on all required MBQIP measures. All 27 CAHs are reporting Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and emergency department transfer communication (EDTC). The Idaho Flex Program, Hospital Improvement and Innovation Network (HIIN) and the Quality Improvement Organization-Quality Improvement Network (QIO-QIN), Qualis Health, meet monthly to discuss initiatives, share ideas, avoid duplication and whenever possible explore opportunities for collaboration. A number of the MBQIP additional measures align with the HIIN. The Idaho Flex Program works to coordinate with the HIIN and the QIN-QIO to avoid a duplication of efforts around MBQIP additional measures.

Program Area: Support for Financial and Operational Improvement: 

The Idaho Hospital Association (IHA) has developed software to collect real-time financial data for all CAHs statewide. This will be the first time Idaho CAHs will be able to report and compare their financial data throughout the state and with Flex Monitoring Team (FMT) reports for peer comparisons. The IHA will disseminate quarterly reports to the Flex Coordinator, CAH Chief Executive Officers (CEOs) and Chief Financial Officers (CFOs) beginning in February 2017. CAHs will then be able to use FMT cost report data for trending, and access the most current financial data from IHA to facilitate quarterly benchmarking. The Flex Coordinator implements onsite technical assistance site visits with all 27 CAHs to meet with the CEO/CFO and discuss FMT data and trends, as well as the IHA initiative to collect and report CAH specific financial data focused on the top ten indicators from the CAH Finance 101 Manual. These visits enable the Flex Coordinator to better assess need and ensure a comprehensive understanding of the data. The Flex Coordinator provides information and/or best practices to the CAHs as needed. In fiscal year (FY)15-FY17, the Flex Coordinator is engaging six CAHs (two per year) to support an in-depth financial/operational assessment. The assessment includes analysis of the ten indicators in the CAH Finance 101 Manual and will enable the creation of an in-depth action plan to address issues in the three targeted facilities.

Program Area: Support for Population Health Management and Emergency Medical Services Integration: 

The Idaho Simulation Network is providing four annual simulation-based team trainings for CAHs and emergency medical services (EMS) agencies serving CAH communities. These trainings allow for real-time training by implementing progressive scenarios in the field (trauma, STEMI or stroke) and target CAHs actively seeking designation for time-sensitive emergencies. Simulation-based team training incorporates telehealth technology (when applicable), as well as official Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS®) methodology to encourage CAH staff and EMS providers to work as a team to complete the scenarios presented.

Program Area: Support for Integration of Innovative Health Care Models: 

The Flex Coordinator released an annual competitive opportunity for all Idaho CAHs exploring health care transformation models. This opportunity allows applicants to develop and implement an innovative health care model that can impact rural health. This competitive application encourages interested CAHs to develop baseline data and targets for improvement related to a specific effort targeting care coordination. This year, Caribou Memorial Hospital in Soda Springs will partner with Bear Lake Memorial Hospital in Montpelier to create a clinically integrated network with a regional tertiary hospital.

Please provide information about any efforts to assist CAHs/communities and partner organizations in the transition to value-based care: 

The Flex Coordinator released an annual competitive opportunity for all Idaho CAHs exploring financial and operational transition to value-based models. This opportunity allows applicants to develop and implement a model that can impact rural health. This competitive application encourages interested CAHs to develop baseline data and targets for improvement related to a specific effort targeting care coordination. This year, Franklin County Medical Center in Preston was awarded to work on implementing an evidence-based, decision-making tool to support accurate documentation that will lead to a decrease in insurance denials. They will create a standardized process to allow for more timely and accurate care transitions and ultimately create efficiencies improving their operating margin and decreasing readmissions.

Please provide information about network activities in your state to support Flex Program activities (such as financial improvement networks, CAH quality networks, operational improvement with CEOs or EHR workgroups): 

All Idaho CAHs interested in forming cohorts around similar MBQIP measures have an opportunity to submit an application for a quality improvement cohort initiative. Every application is reviewed and scored by an impartial Flex Advisory Committee. One competitive application was awarded this year and focused on MBQIP-related quality improvement measures. The CAH cohort is required to establish baseline data and targets for the quality improvement efforts focused on selected MBQIP additional measures. This year three initiatives were awarded:

  • The four CAHs in the St. Luke’s Health System (Elmore, Jerome, McCall and Wood River) are implementing a quality improvement project to improve EDTC outcomes
  • The Hospital Cooperative has 11 CAHs in southeastern Idaho working to develop an antimicrobial stewardship program in each facility to reduce health care acquired infections in Montpelier, Blackfoot, Soda Springs, Preston, Arco, Rupert, Malad, Gooding, American Falls, Salmon and Driggs
  • Weiser Memorial Hospital and Valor Health are also working together to implement antimicrobial stewardship programs in their respective communities of Weiser and Emmett Idaho

The information and best practices gathered from these cohorts will inform future trainings and be shared during site visits.

Please provide information about cross-state collaborations you may be working on related to the Flex Program: 

The Flex Program Coordinator is participating in the planning committees for the Northwest Rural Health Conference in Seattle, Washington as well as the Western Region Flex Conference in Hawaii.

From the last Flex Program year, please describe a best practice you would like to share with other states: 

The Idaho Flex Coordinator implements onsite technical assistance site visits to each CAH. These visits provide an opportunity to discuss all MBQIP required measures and address any hospital-specific barriers/challenges to reporting/improving the measures. Information and best practices gathered during site visits are used to strengthen trainings. These visits also allow the Flex Coordinator to recruit CAHs to participate in cohorts around similar quality improvement efforts focused on MBQIP required and additional measures, and provide an opportunity to share best practices and lessons learned from existing cohort initiatives. The Idaho Flex program, HIIN and QIO-QIN meet monthly to discuss initiatives, share ideas, avoid duplication and, whenever possible, explore opportunities for collaboration. The group has collectively formed the Idaho Healthcare Quality Consortium to provide a SharePoint site for all hospitals to obtain quality improvement information and details on all of the statewide and national initiatives that require quality reporting, including MBQIP related initiatives.

Program Statistics

What type of organization is your Flex office housed in?: 
State Government
What is the number of full time employees (FTE) in your Flex office?: 
How many CAHs are in your state?: 
Do you have any hospitals interested in converting to CAH status?: 

Additional Information

Flex Program Staff

Mary Sheridan
State Office Director, Idaho
(208) 332-7212

Specialty Areas / Background

Mary is a registered nurse. Her specialty areas include rural emergency medical services, nursing, health care quality, and patient safety.

State Office Director since October 2003 

Stephanie Sayegh
Flex Coordinator, Idaho
(208) 332-7363

Specialty Areas / Background

Stephanie has a M.A. in International Affairs with a focus on socio-economic development. She has supported a variety of health programs in Honduras, Sierra Leone, and Mozambique.

Flex Coordinator since November 2013

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, $1,100,000 (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.