Kansas State Flex Profile

Top Flex Activities

Program Area: Support for Quality Improvement: 

Grant resources are focused on carrying out the required Activities 1.01 through 1.04 as outlined in the funding opportunity announcement (FOA). Work plan activities are accomplished with the Kansas Flex Program’s involvement in the Kansas Quality Improvement Partnership (KQIP). In 2012, KQIP came together to maximize resources dedicated to improving quality and to eliminate or reduce duplication of efforts by Kansas providers. The KQIP is a group of leading health care organizations that strive to coordinate quality improvement and patient safety initiatives for health care providers. KQIP includes the Kansas Healthcare Collaborative (KHC), Kansas Hospital Association (KHA), Kansas Foundation for Medical Care (KFMC), Kansas Medical Society (KMS) and Kansas Department of Health and Environment (KDHE), including the Primary Care and Rural Health Program and the Healthcare-Associated Infections Advisory and Planning Committee. This group provides the collective expertise and voice for quality and patient safety in Kansas.

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: 

The state has consistently been behind the national average as it relates to CAHs and quality data reporting, making the ability to strategically build targeted interventions towards the areas of highest need a challenge. In order to eliminate the reporting rate disparity in Kansas CAHs, the State Office of Primary Care and Rural Health (SOPC) has been actively involved with the KQIP’s efforts to promote voluntary reporting of quality data. To this end, the SOPC has worked to incentivize active participation by incorporating reporting expectations for any hospital participating in the Kansas Flex-supported initiative and/or to receive the Kansas Small Rural Hospital Improvement Grant Program (SHIP) funding. Additionally, the SOPC has supported KQIP in assuring accessible quality reporting education, training and technical support available to Kansas CAHs.

Through these collective efforts, the number of Kansas CAHs reporting quality measures have increased significantly:

  • The percentage of Kansas CAHs reporting outpatient data to the Centers for Medicare & Medicaid Services (CMS) through one quarter increased from 25.3 percent in 2013 (Q2-Q1) to 89.3 percent in 2015 (Q1-Q4)
  • The percentage of Kansas CAHs reporting four quarters of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data increased from 19.3 percent in FY2013 (Q2-2012 to Q1-2013) to 75.2 percent in FY2016 (Q2-2015 to Q1-2016) 
Program Area: Support for Financial and Operational Improvement: 

Grant resources are focused on carrying out the Financial and Operational In-depth Assessment(s) and Action Planning and Revenue Cycle Management. Specific work plan sub-activities are as follows.

  • Support hospitals in defining clinical and operational staffing benchmarks and determine staffing appropriateness to meet the future community needs through two phases:
    • Phase 1: In-depth statewide assessment and benchmarking tool development
    • Phase 2: Targeted in-depth assessments and/or consultation to select hospitals modeling the small hospital transition project framework
  • Assist CAH leadership in strategically preparing for new payment and care delivery models by:
    • Supporting focused facilitation and consultation to assess hospital’s current system affiliations and/or relationships
    • Examining hospitals’ needs and merits of further system affiliations/relationships
    • Planning for future opportunities to build new system affiliations
  • Provide direct targeted consultation and coaching to select hospitals in creating effective revenue cycle management teams and implementing best practice standards for internal revenue control processes and management
  • Educate hospital financial and business managers and leaders to grow their knowledge and skills around key financial performance indicators and effective strategies for improving their revenue cycle management
Program Area: Support for Population Health Management and Emergency Medical Services Integration: 

The Kansas Flex Program emergency medical services (EMS) work plan is geared around the following activity areas:

  • Improve integration of EMS in local/regional systems of care
    • Conduct Community-level Rural EMS System Assessments
    • Assist frontier communities of northwest Kansas in assessing EMS system capacity and identifying regional strategies to meet future needs in two phases
      • Phase 1: Northwest Kansas Regional EMS Strategic Assessment
      • Phase 2: Targeted technical assistance to build regional system EMS capacity and structures
  • Engage rural health providers and communities to conduct a local assessment of their EMS system
    • In year two and three, the Kansas Flex Program will facilitate community-level assessments to identify long-term strategies for a sustainable rural EMS system
  • Improve local/regional EMS capacity and performance in CAH communities
  • Improve EMS capacity and operational projects
  • Aid rural hospital and EMS agency in creating strategies to advance hospital and EMS performance and partnership
  • Provide training to rural EMS medical directors, strengthening quality and performance improvement competencies
    • Phase 1: Target the coordinated plan for rural EMS medical directors education
    • Phase 2: Target Core Competency Training for EMS Medical Directors (including stroke, STEMI and trauma)
  • Improve identification and management of time-critical diagnoses
  • Educate and provide technical consultation to EMS agencies in adopting the Centers for Disease Control and Prevention (CDC) field triage guidelines for trauma
  • Build EMS workforce capacity and scientific knowledge of evidence-based stroke and ST-segment elevation myocardial infarction (STEMI)
    • Phase 1: Assessment of the EMS agency’s readiness and capacity to use of Stroke/STEMI best practices and evidence-based protocols
    • Phase 2: Support the Kansas Initiative for Stroke Survival efforts in state-wide data collection, development of educational resources/tools and information dissemination
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): 

Kansas state statutes require that all CAHs are part of a rural health network, which is defined as "an alliance of members including at least one CAH and at least one other hospital which has developed a comprehensive plan submitted to and approved by the secretary of health and environment units regarding patient referral and transfer, the provision of emergency and non-emergency transportation among members, the development of a network-wide emergency services plan and the development of a plan for sharing patient information and services between hospital members concerning medical staff credentialing, risk management, quality assurance and peer review." As such, the Flex Program has approximately one dozen state-designated rural health networks across Kansas who provide various levels of service to the CAHs. More information can be found at http://krhop.net/cahs_networks.php

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

With help from Stratis Health, a monthly emergency department transfer communication (EDTC) data collection tool has been created. With the creation of this tool, a newly developed import function allows the data collected in the tool to be transferred into a multi-state benchmarking system designed for small rural hospitals to compare selected measures with other similar hospitals. Kansas CAHs can compare data and share best practices not only among themselves but with CAHs in all participating states. Additionally, the Kansas Flex Program is able to gather the aggregated EDTC data using the benchmarking system report function to compile and complete the required quarterly reports to the Federal Office of Rural Health Policy. Both the tool and the import function support reporting of EDTC data on a monthly basis. A series of workshops is underway to train CAHs on EDTC data measures and reporting with the monthly data collection tool and benchmarking system.

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

This last year's assessment results led the Kansas Flex Program to design a targeted initiative aimed at providing CAH leadership strategic consultation to assess a hospital’s current system affiliations/relationships, examine hospital's needs/merits of further system affiliations/relationships and plan for future opportunities to build new system affiliations. KHA will be engaging a subcontractor to design and implement a multi-hospital initiative to develop a process and set of tools that an independent hospital could use with their board and senior teams to consider an affiliation with a larger organization or system, and examine options for the best model for the affiliation. Hospital recruitment and selection for this initiative kicked off in summer 2016 with three small CAHs.

Program Statistics

What type of organization is your Flex office housed in?: 
State Government
How many CAHs are in your state?: 
Do you have any hospitals interested in converting to CAH status?: 

Additional Information

Flex Program Staff

Cynthia Snyder
State Office Director, Kansas

Specialty Areas / Background

Cynthia Snyder joined the Bureau of Community Health Systems in October 2017. Prior to joining the Special Population Health, Primary Care and Rural Health team, Cynthia was with the Bureau of Health Promotion focused on access to primary health care services for low-income and medically underserved populations through the Early Detection Works program.

State Office Director since October 2017

Ashley Wallace
Flex Coordinator, Kansas
(785) 296-5751

Flex Coordinator since July 2017

Jennifer Findley
Hospital Performance Improvement Coordinator, Kansas
(785) 233-7436

Hospital Performance Improvement Coordinator since March 2015

Susan Runyan
MBQIP Coordinator, Kansas

MBQIP Coordinator since October 2016

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.