Flex (Medicare Rural Hospital Flexibility Grant Program)
The North Dakota Medicare Rural Hospital Flexibility (Flex) Program is a state based partnership that works with and assists all rural hospitals to stabilize and sustain their local healthcare infrastructure. Flex is a companion to the Critical Access Hospital (CAH) designation process. Hospitals receive CAH designation from the Center for Medicare and Medicaid Services (CMS).
The Balanced Budget Act of 1997 created the Medicare State Rural Hospital Flexibility Program. The purpose of
the program is to assist rural hospitals and to improve access to health services in rural communities. The
Flex program provides funding to States for the designation of Critical Access Hospitals (CAHs) in rural
communities. CAH conversion can allow for enhanced service diversification and combines potentially improved
(cost-based) reimbursement with savings from relaxed operating requirements to help ensure the financial
viability of participating hospitals.
The Flex Program helps to sustain the rural healthcare infrastructure by strengthening critical access
hospitals thereby maintaining access to care for rural residents. By applying the components of Flex (State
Rural Health Plan,conversion to critical access hospital, network development, quality improvement and
emergency medical services integration initiatives), the program fosters the growth and sustainment of rural
collaborative healthcare systems across the continuum of care.