Rural Hospital Sustainability Resources

The purpose of the Flex program is to support the long-term sustainability of critical access hospitals (CAHs) and related health services in rural areas across the nation.

Funded by HRSA, this ongoing grant program supports CAHs and statewide partners to improve quality of care, finances/operations, population health, emergency medical services (EMS) and/or supporting hospital transition to other organizational models that might better serve their communities.

The budget period for this grant runs from Sept 1 to Aug 31 each year. Sub-grant interim reports are usually quarterly and a final report is due in early September.

Current/recent funded projects:

• Vermont Program for Quality in Health Care, Inc. (VPQHC) – technical assistance and peer learning to support data reporting, quality improvement, and cardiovascular disease management.
• VPQHC recently coordinated: health equity trainings, telehealth services, quality framework development and suicide prevention planning in emergency departments.
• Vermont Ethics Network (VEN) – staff/provider training on end-of-life planning and ethical decision-making; translation of key end-of-life documents into multiple languages, including for the hearing and visually impaired.
• New England Rural Health Association (NERHA) – access to professional development courses through Institute for Healthcare Improvement (IHI), certification courses, regional conferences and webinars related to rural health care.
• CAH-specific projects (when funding allows) – partial reimbursement of costs related to revenue cycle management improvement, chargemaster updates and process improvements.

The purpose of the SHIP is to support small rural hospitals to make the transition to value-based payments and full participation in Accountable Care Organizations (ACOs).

Allowable investments by eligible hospitals (fewer than 50 beds) under this program include: software and training related to value-based purchasing, shared savings or ACO participation, or bundled payments.  HCAHPS data collection is a common reimbursed expense.

Eligible entities: Critical Access Hospitals (CAHs) & Brattleboro Memorial Hospital

The budget period for this grant runs from June 1 to May 31 each year. Sub-grant interim reports are required semi-annually and a final report is due in early June.

Typical sub-grant amounts are around $13,800/hospital, reimbursed in January & June.

Current/recent funded projects:

• Reimbursing expenses for HCAHPS data collection and improvement.
• Staff training to improve care and services for homeless and/or LGBTQI persons.
• Other projects related to:   Quality improvement or Performance Improvement.
• Allowable expenses at:  Allowable Investments for SHIP funds 

The purpose of the SORH grant is to help States share information among federal, state and local partners; coordinate rural health activities; and reduce duplication among stakeholders.

Also funded by HRSA, this grant supports workforce data collection, analysis and reporting for 40+ professions; extension of Flex-funded QI, training and support to non-CAH partners through sub-grants to Vermont Program for Quality in Health Care (VPQHC), Vermont Ethics Network (VEN), New England Rural Health Association (NERHA) and other partners.

Rural Healthcare Provider Transition Project (RHPTP)

RHPTP guides small rural hospitals and certified rural health clinics as they prepare for participation in alternative payment and care delivery models.

National Rural Health Resource Center (ruralcenter.org) Resources 

The Center's searchable Resource Library features articles, reports, webinars, podcasts, toolkits, and other materials developed by trusted industry leaders to guide and support rural health stakeholders.

Flex Monitoring Team 

Several national research centers support States and rural hospitals to evaluate the impact of the Medicare Rural Hospital Flexibility grant program and provide blinded comparison data for critical access hospitals (CAHs) on quality, finances, community engagement.