Michigan State Flex Profile

Top Flex Activities

Program Area: Support for Quality Improvement: 

In this program area, Michigan will:

  • Support the Michigan Critical Access Hospital (MICAH) Quality Network (QN) activities
  • Support member quarterly meetings, provide follow-up activities and support a listserv
  • Support data benchmarking of MICAH QN core measures
  • Support the Medicare Beneficiary Quality Improvement Project (MBQIP)
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 MICAH QN continues to be a success in the state of Michigan. The group has consistently worked together to improve on a variety of measures. Currently, they have a workgroup analyzing the emergency department transfer communication (EDTC) data to determine what resources are needed to raise the bar with EDTC 4 and EDTC 5.

Program Area: Support for Financial and Operational Improvement: 

In this program area, Michigan will:

  • Continue recruitment of all critical access hospitals (CAHs) to participate in the Financial Benchmark Group (currently 12 of 36 CAHs are participating)
  • Support bi-yearly meetings
  • Encourage Chief Financial Officer (CFO) efforts to submit financial benchmarks into a benchmarking tool
  • Support hospital board of director training
  • Support hospital service line analysis
  • Support inpatient and outpatient Lean analysis
Program Area: Support for Population Health Management and Emergency Medical Services Integration: 

In this program area, Michigan will:

  • Support population health management needs assessments based on community health needs assessments (CHNA)
  • Support community-level rural emergency medical services (EMS) system assessment by conducting a Michigan Rural Systems Assessment Report
  • Sponsor EMS Leadership Academy Workshops, levels I-IV
Program Area: Support for Integration of Innovative Health Care Models: 

Michigan provides support for the Rural Health Clinic Quality Network.

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

The Michigan State Office of Rural Health (SORH) continues to provide education on value-based purchasing programs, current and future models. The Michigan Center for Rural Health (MCRH) is the State-Based Executive Director for two Michigan rural accountable care organizations (ACOs). MCRH was able to share learnings from this project with CAHs not involved. In addition, MCRH subcontracts with the Transforming Clinical Practice Initiative (TCPI) awardee for Michigan to provide value-based education to rural providers, including CAHs. 

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): 

Michigan has the MICAH QN. All 36 CAHs in Michigan, including three prospective payment system (PPS) hospitals, belong to the MICAH QN. They are a 501(c)(3) organization and members attend quarterly quality meetings and communicate with each other via listserv. Composition of the Network includes Directors of Nursing (DON), quality directors, patient safety managers, hospital administrators and managers.

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

The Michigan Flex Program has developed a Rural Health Clinic Quality Network (RHC QN) that meets quarterly. Measures have been developed and rural health clinics (RHCs) are submitting to a benchmarking tool. The measures are tobacco cessation, controlling high blood pressure and body mass index (BMI) screening and follow-up. Thirty-three RHCs are participating in collecting the measures and over 65 RHCs are active in the RHC QN meetings. 

Program Statistics

What type of organization is your Flex office housed in?: 
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

Rural Health Plan: 

Flex Program Staff

John Barnas
State Office Director, Michigan
(517) 432-9216
Crystal Barter
Flex Coordinator, Michigan
(517) 432-0006
Emma Smythe
Rural Health Programs Coordinator, Michigan
(517) 355-7757
Sara Wright
Community Programs Assistant, Michigan
(517) 353-3990
Jeff Nagy
Quality Improvement Advisor, Michigan
(517) 884-8641

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.