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Ohio Department of Health

Top Flex Activities

Program Area: Support for Quality Improvement

The Ohio Flex Program collaborates with the quality improvement organization (QIO) for Ohio, Health Services Advisory Group, Inc., to improve patient safety in critical access hospitals (CAHs) and the community by ensuring all health care providers and eligible patient populations receive their influenza vaccinations. Ohio seeks to increase the number of CAHs reporting HCP/OP-27 data to 33 (100 percent) and ensure that all CAHs are trained on entering HCP/OP-27 data, running and utilizing reports.

The Ohio Flex Program seeks to improve the transitions of care with emergency department transfer communication (EDTC) from the CAHs to other health care settings in order to improve patient outcomes and increase the percentage of CAHs reporting EDTC measures.

The Ohio Flex Program continues to maintain and support the Flex Quality, Financial and Operational Improvement Network (Flex QI Network) with the use of a consultant for quality improvement services and training for CAHs. The Flex QI Network has existed since 2004 and is supported by subcontractors in benchmarking, web-based reporting, and quality measures improvement, technical assistance, and training.

Program Area: Support for Financial and Operational Improvement

The Ohio Flex Program is focused on the following financial and operational improvement projects:

  • conducting a financial and operational assessment with use of a consultant;
  • maintaining and supporting the financial and operational workshops within the Flex QI Network;
  • facilitating the sharing of best practices, resources, and expertise regarding financial and operational projects within the Flex QI Network;
  • utilizing the tools purchased through the Small Rural Hospital Improvement Grant Program (SHIP) funding for quarterly benchmarking and individual analysis of financial and operational improvement with the Flex subcontractor;
  • providing two workshops and/or webinars with experts to educate CAHs on financial and operational evidence-based practices;
  • and conducting a financial and operational in-depth assessment and action plan with the use of a subcontractor.

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

The Ohio Flex Program is engaged in population health management and emergency medical services (EMS) integration through the following activities: 

  • conducting a statewide CAH population health management needs assessment, including updating CAHs' community health needs assessments (CHNAs) through use of a subcontractor;
  • developing a network of EMS and safety net providers within four county-level EMS systems in southeast Ohio;
  • and conducting a community-level rural EMS system assessment utilizing the existing data from the Ohio Department of Public Safety and a subcontractor to identify capacity and performance issues and identify priorities for CAH communities.

Please provide information about Collaboration/Shared Services.

The Ohio Flex Program, in collaboration with the Ohio State Office of Rural Health (SORH) and the Ohio Department of Health, is updating the Ohio State Rural Health Plan which will include EMS, population health, CHNA, and market assessment data of CAHs, small and rural hospitals, local health departments, rural health clinics, other health care providers, and community organizations. Additionally, the Flex Program and SORH are active participants in the Ohio Healthcare Quality Collaborative (consisting of the Ohio Department of Health Diabetes program, Department of Aging, Ohio Hospital Association, QIO, Ohio Pharmacists Association, Ohio Health Information Partnership and its quality innovation network (QIN)).

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

The SORH partners with another organization to make assessments for interested Ohio CAHs on what their potential reimbursement rates would be under a value-based model. This assessment also identifies areas for improvement that would increase such reimbursements. In addition, the state office supports individual value-based care projects through SHIP funding.

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

The Ohio Flex Program created the Flex QI Network in 2004, and it has grown and maintained momentum and continued participation. The Flex QI Network focuses on quality, financial, and operational improvement through training and technical assistance. There are over 55 participants, including Chief Executive Officers (CEOs), Chief Financial Officers (CFOs), directors of nursing, and other quality staff from all 33 CAHs.

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

The Ohio Flex Program offers CAHs several services in collaboration with a partnering organization focused on data, including:

  • payor optimization;
  • market assessment;
  • and operational assessment.

Do you have any hospitals interested in converting to CAH status?:


Program Statistics

Type of Organization State Government
Staffing 1.8 FTEs
Number of CAHs 33
Website URL Organization Website

Flex Program Staff

Shane Ford
State Office Director, Ohio

State Office Director since October 2017


Daniel Prokop
Flex Coordinator, Ohio

Specialty Areas/Background

  • Master of Science in Health Systems Administration
  • Lean Six Sigma Green Belt
  • Worked in project management at 2 large health systems
  • Managed a housing program at a small AIDS Service Organization
  • Grant management experience

Flex Coordinator Since December 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.