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).Overview
Program Purpose
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.
Program Mission
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
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North Dakota Hospital Assessment: 2014 Chartbook
This 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).Author(s): Schroeder, S., Hart, G., Gibbens, B., Dickson, L., Peterson, M. & Ahmed, A.
Date: December 2014
Type: Report -
What is a Community Health Center?
Non-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.Author(s): Morin, K., Barclay, M.
Publication: North Dakota Medicine, 38(3), 20-21
Date: October 2013
Type: Magazine -
CAH Financial Conditions and Concerns
Summarizes 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.Author(s): Miller, M., & Gibbens, B.
Date: March 2012
Type: Fact Sheet -
Critical Access Hospital Organizational Conditions
Includes survey results from North Dakota CAHs. Examines how certain environmental conditions shape the organization structure of CAHS, how they operate, and services they offer. Part of a series of fact sheets on Critical Access Hospitals and the North Dakota Medicare Rural Hospital Flexibility (Flex) Program.Author(s): Miller, M., & Gibbens, B.
Date: March 2012
Type: Fact Sheet -
Hospital Networks
Discusses hospital networks. Part of a series of fact sheets on Critical Access Hospitals and the North Dakota Medicare Rural Hospital Flexibility (Flex) Program.Author(s): Miller, M., & Gibbens, B.
Date: March 2012
Type: Fact Sheet
Most Recent Presentations
- The Community Health Needs Assessment Process in North Dakota: The Importance of Community in Community Health
Presented by Gibbens, B. on Aug 09, 2017 at the University of North Dakota Center for Family Medicine, Minot, North Dakota - Nobody Knew Healthcare Could be so Complicated
Presented by Gibbens, B. on Mar 30, 2017 at the Northwood Deaconess Health Center, Northwood, North Dakota - Preliminary Analysis of Community Health Needs Assessments (CHNA) Prioritized Issues
Presented by Gibbens, B. on Oct 26, 2016 at the State Health Data Retreat, Bismarck, North Dakota - A Changing Healthcare Picture in North Dakota But Community is Still Key
Presented by Gibbens, B. on Oct 18, 2016 at the Ashley Medical Center Annual Meeting, Ashley, North Dakota - Health Reform and the Community
Presented by Gibbens, B. on Sep 28, 2016 at the West River Health Services Community Annual Meeting, Hettinger, North Dakota