Flex Grant
Medicare Rural Hospital Flexibility (FLEX/CAH) Program

This website is funded by the California Department of Health Services, State Office of Rural Health, through a grant from the Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy.

The Medicare Rural Hospital Flexibility (FLEX/CAH) Program provides Critical Access Hospitals (CAHs) and eligible CAHs with resources and expert services; monitors and ensures the completion of sub-contracted FLEX/CAH technical assistance and services, including Quality Improvement (QI) and Emergency Medical Services (EMS) training and projects; and, supports the network activities of the California Critical Access Hospital Network (CCAHN).

Although focused on small, rural hospitals, the Flex program operates on the National, State, community, and facility levels to cover a broad range of fundamental health service issues and “modernization” goals. State use Flex resouces for performance management activities, training programs, needs assessments, and network building. Efforts have included the use of a balanced scorecard approach, forming relationships with state Quality Improvement Organizations (QIOs), developing quality improvement-related networks, and participating in national quality improvement and reporting efforts.

The Flex program requires States to develop rural health plans, and funds their efforts to implement community-level outreach and technical assistance to advance the following goals:

  • Improve quality of care and performance management
  • Improve and integrate EMS
  • Develop and implement rural health networks
  • Support existing CAHs and eligible hospitals
  • Designate CAHs in the State

Only states with Critical Access Hospitals (CAH) or potential CAHs are eligible for the Flex program.


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