Rural Hospital Flexibility Program (FLEX)

The Medicare Rural Hospital Flexibility Grant Program was authorized by Section 4201 of the Balanced Budget Act of 1997 (BBA), Public Law 105-33 and was reauthorized by Section 121 of the Medicare Improvements for Patients and Providers Act of 2008, Public Law 110−275.

The Medicare Rural Hospital Flexibility Program (MRHFP, referred to as the Flex Program) is an ideal mechanism for supporting improvements in the quality of health care provided in communities served by Critical Access Hospitals (CAHs), supporting efforts to improve the financial and operational performance of the CAHs, and supporting communities in developing collaborative regional and local delivery systems.

Only States with certified Critical Access Hospitals are eligible for this Grant Program.

The Flex program focuses on four core areas:

  1. Support for Quality Improvement in CAHs (more…)
  2. Support for Operational and Financial Improvement in CAHs (more…)
  3. Support for Health System Development and Community Engagement, including integrating EMS in regional and local systems of care (more…)
  4. Facilitate Conversion of Small Rural Hospitals to CAH status (more…)
Visit the federal government’s Flex website at: