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.
Most Recent Publications
- North Dakota Hospital Assessment: 2014 Chartbook
Schroeder, S., Hart, G., Gibbens, B., Dickson, L., Peterson, M. & Ahmed, A. December 2014This Chartbook presents the findings of the 2014 survey of hospitals in North Dakota. This resource does not provide analysis or discussion of the results, but instead, offers a graphic discourse on the current hospital environment in the state. Output includes aggregate data stratified by geographic region (Northwest, Northeast, Southeast, Southwest) and hospital type (CAH or tertiary).
- What is a Community Health Center?
Morin, K. & Barclay, M.
North Dakota Medicine, Volume 38 Issue 3 Pages 20-23, October 2013Non-profit community-driven clinics provide high-quality primary and preventive care to all individuals, with or without insurance and regardless of their ability to pay.
- North Dakota Rural Hospitals and Emergency Medical Services Collaboration
Miller, M., & Gibbens, B. March 2012Results of a survey amongst North Dakota's 36 CAHs and their relationship with local EMS providers. Part of a series of fact sheets on Critical Access Hospitals and the North Dakota Medicare Rural Hospital Flexibility (Flex) Program.
- CAH Financial Conditions and Concerns
Miller, M., & Gibbens, B. March 2012Summarizes the current financial status of North Dakota CAHs. Part of a series of fact sheets on Critical Access Hospitals and the North Dakota Medicare Rural Hospital Flexibility (Flex) Program.
- Hospital Networks
Miller, M., & Gibbens, B. March 2012Discusses hospital networks. Part of a series of fact sheets on Critical Access Hospitals and the North Dakota Medicare Rural Hospital Flexibility (Flex) Program.
Most Recent Presentations
- What do North Dakota CAH Administrators Really Think About Rural Health? Findings and Implications from the 2014 CAH CEO Survey
Presented by Gibbens, B. on Jun 03, 2015 at the Dakota Conference on Rural and Public Health Pre-Conference, Minot, ND
- The Opportunity of Rural Health: Challenges and Options for Change
Presented by Gibbens, B. on Nov 13, 2014 at the North Dakota Healthcare Financial Management Association (HFMA), Minot, North Dakota
- North Dakota Flex Program & CAH Quality Network Update
Presented by Ward, J. on Jun 18, 2014 at the Critical Access Hospital Pre-Conference, Grand Forks, North Dakota
- Resources to Address Community Health Needs: Federal Rural Health Outreach Grant Program and its Impact in North Dakota
Presented by Gibbens, B. on Jun 18, 2014 at the 2014 CAH Pre-Conference Dakota Conference on Rural and Public Health, Grand Forks, North Dakota
- Community Health Needs Assessments: Process and Results in North Dakota
Presented by Gibbens, B. on Jun 17, 2014 at the North Dakota Hospital Association Board of Directors, Grand Forks, North Dakota