Medicare Rural Flexibility Grant Program

The Medicare Rural Hospital Flexibility (FLEX) Program is a federal funding program that aims at working with rural hospitals to stabilize and sustain their local health care infrastructure. The goal of the FLEX grant is to improve the quality of care and financial and operational performance, as well as manage population health needs. The Medicare Beneficiary Quality Improvement Program (MBQIP) is the quality portion of the grant that provides an opportunity for individual critical access hospitals to look at their own data, measure their outcomes against each other and partner with other hospitals in the state around quality improvement initiatives to improve outcomes and provide the highest quality care to every patient. Read more about the FLEX program here.

  • Spotlight
  • Quality Resources
  • Population Health Resources
  • Financial and Operational Resources
  • Presentations
Spotlight Hospital: Cox Monett Hospital
Zachary Carnes, MHA, RT(R)(CT)
View Zachary's presentation.

Spotlight Hospital: Scotland County Hospital
Terri Schmitt, MHA, CPHQ
View Terri's presentation.

Spotlight Hospital: Putnam County Memorial Hospital
Christina Davis, R.N., BSN
View Christina's presentation.

FLEX Sign Up Information

List of Missouri FLEX Critical Access Hospitals


MBQIP Quality Reporting

NHSN Resources


ED Transfer Data Collection Tool and Resources


Rural Hospital Performance Improvement Project
As one of the states included in the Delta Region, several Missouri hospitals have access to education and services provided under the Rural Hospital Performance Improvement project run by the National Rural Health Resource Center. MHA has learned that all hospitals are eligible to access the recorded webinars provided by the National Rural Health Resource Center. The topics range from community health needs assessment to revenue cycle management, with several other topics.

Quality Improvement Basics for Rural Health Care Organizations

MHA Resources

Agency and Organizations

FLEX Resources

The complimentary FLEX orientation and overview will provide participants with a basic knowledge of the different aspects of the grant – quality reporting and improvement, financial and operational excellence, and population health management. These short presentations are designed for hospital teams new to the FLEX grant or new to health care. For a more robust training or overview, please contact MHA staff listed on the slides for each respective section of the grant.

MHA Presentations

Regional Meeting Presentations
  • FLEX – MBQIP Regional Meeting (March 2019) - PowerPoint
  • FLEX – MBQIP Regional Meeting (November 2019) - PowerPoint

FLEX Update Presentations
  • FLEX – MBQIP and Updates (June 2019) - PowerPoint | Recording
  • Emergency Department Transfer Communication Updates (January 2020) - PowerPoint
  • Integrating Population Health in Health Care (February 2020) - PowerPoint | Recording
  • New CMS Update Impacting Critical Access Hospitals (February 2020) - PowerPoint

CAH Presentations
Medicare Rural Hospital Flexibility Program Financial and Operational Webinar Series

All recordings will be uploaded upon completion. To access PowerPoint presentations, please email Karen Purdy and specify the title of the presentation you are requesting.

  • Key Financial Metrics and Impacts on Operations; Understanding Market Share and Capture Rates; 340B Strategies (May 21, 2020)
  • Cost Reimbursement Impacts to Volume and Expense Changes; Physician Compensation and Productivity (June 3, 2020)
  • Cost Reimbursement Strategies and Service Line Considerations; Understanding CAH Reimbursement Drivers; Service Line Profitability for CAHs (June 25, 2020)
  • RHC Operations and Strategy; Coding and Billing Basics (July 16, 2020)
  • CMS New Price Transparency Requirements for Hospitals (July 30, 2020)
  • Using KPIs in Revenue Cycle Management; Revenue Integrity and Denials Management (August 6, 2020)
  • Strategies for CFO Communications to the Board; Board Governance: Insights into Trustee Roles and Responsibilities (August 26, 2020)

Access the webinar series.