Rural Hospital Medicare Flexibility Program (Flex)

The Rural Hospital Medicare Flexibility Program (Flex Program) grant is awarded to Iowa HHS by the Health Resources Services Administration’s (HRSA’s) Federal Office of Rural Health Policy.

Through the Flex Program grant, HHS contracts with organizations to implement activities related to quality improvement, financial improvement, operational improvement, and population health. Eligible critical access hospitals (CAHs) are able to participate in these activities at no cost. Currently, activities are provided by the Iowa Healthcare Collaborative, HomeTown Health, and HHS, as summarized below. 

Quality Improvement

The quality improvement area includes MBQIP data. Submitting MBQIP data is the only requirement for critical access hospitals to participate in the Flex Program. If critical access hospitals meet the MBQIP reporting requirements, they are automatically able to participate in Flex Program activities.

Iowa Healthcare Collaborative sends MBQIP reports to hospitals and provides technical assistance, webinars/calls, and live events related to quality improvement.

Financial Improvement

HomeTown Health provides financial improvement webinars, triage resources, live meetings, comparative dashboards, in-depth assessments and action planning, and peer assistance.

Operational Improvement 

HomeTown Health provides operational improvement webinars, live meetings, comparative dashboards, in-depth assessments and action planning, and peer assistance.

Population Health 

Iowa Healthcare Collaborative provides community health needs assessment technical assistance webinars. Iowa HHS provides individual technical assistance.

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Small Rural Hospital Program (SHIP)

The Small Rural Hospital Improvement Grant Program (SHIP) is coordinated through the Health Resources and Services Administration's (HRSA) Federal Office of Rural Health Policy (FORHP). SHIP provides funding to hospitals in 46 participating State Offices of Rural Health (SORH) to help small rural hospitals engage in various Affordable Care Act (ACA) delivery system reforms, such as value-based purchasing programs, accountable care organizations, prospective payment systems and payment bundling.

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