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Indiana State Office of Rural Health

Top Flex Activities

Program Area: Support for Quality Improvement

Indiana's Medicare Beneficiary Quality Improvement Project (MBQIP): 

  • Aids critical access hospitals (CAHs) in publicly reporting specific inpatient and outpatient measures to Hospital Compare as well as reporting on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures and emergency department transfer communication (EDTC) measures
  • Provides technical assistance to CAHs to implement quality improvement (QI) initiatives to improve patient safety scores, HCAHPS scores, EDTC scores and outpatient scores

These initiatives allow for improvements to health care service, processes and administration. Indiana also provides CAH Quality Education Programs focused on quality improvement and leadership development.

Please share a success story about reporting quality data or using quality data to help CAHs in your state improve patient care.

Indiana was one of 10 states recognized by the Health Resources and Services Administration (HRSA) as having top performing CAHs. The recognition looked at quality performance in regards to achieving high reporting rates and reporting improvement from year to year.

Program Area: Support for Financial and Operational Improvement

Indiana focuses on the following initiatives:

  • Annual conference on financial improvement and hospital operational topics for CAHs to discuss their financial and operational needs and share best practices among peers
  • Fifteen CAHs participating in the Studer Group Rural Collaborative Coaching Model (RCCM)
  • Fifteen CAHs participating in process improvement and rapid improvement event trainings

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

CAH community health needs assessments (CHNA) are reviewed annually and analyzed to identify specific health needs of CAH communities. The CHNAs provide a brief overview of the hospital and allow the Flex Program to have some knowledge in advance while talking to hospitals.

The Indiana State Office of Rural Health is working with CAHs and local first responders to develop community paramedicine payment models to be introduced to the Centers for Medicare & Medicaid Services (CMS).

Please provide information about Collaboration/Shared Services

The Indiana State Office of Rural Health is working with CAHs and local first responders to develop community paramedicine payment models to be introduced to CMS.

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

The Indiana State Office of Rural Health is working with CAHs and local first responders to develop community paramedicine payment models to be introduced to CMS.

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

The Flex Quality Network Council meets every other month via webinar to provide CAH quality staff updates on MBQIP, share best practices and provide updates from the quality improvement organization (QIO).

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

One of Indiana's contractors, Valiant Health, is working with Illinois on a program designed to improve HCAHPS scores. Groups are divided into subgroups, and meet on a regular basis to discuss how these practices are being implemented and things they have learned from it.

Please describe how your state Flex Program has enhanced its use of data in the past year.

Indiana is currently working to create a database for its information that will be manipulatable in Tableau. After attending the Rural Health Data Summit this year, this program got the members of the Flex team excited for new ways to utilize data within the organization.

Program Statistics

Type of Organization State Government
Staffing 1.5 FTEs
Number of CAHs 35
Website URL None listed

Flex Program Staff

Ann Alley
State Office Director, Indiana
(317) 233-7451

Specialty Areas / Background

  • Health care
  • Housing
  • Economic development

State Office Director since July 2009

Abigail Garcia
State Office Manager, Indiana
317-234-2300

State Office Manager since February 2017

David Conrad
State Flex Coordinator, Indiana
317-234-2885

State Flex Coordinator since February 2017

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.