Flex Program

Flex Program

About the Flex Program

The Rural Hospital Flexibility Grant Program, also known as the Flex Program, is a federally funded grant program, established by the Balanced Budget Act of 1997. The Flex program assists Critical Access Hospitals in four core areas: (1) Quality Improvement, (2) Financial and Operational Improvement, (3) Health System Development and Community Engagement, (4) CAH Designation. More information from the U.S. Health Resources and Services Administration (HRSA) about the Flex program is available.

The Oregon Flex program currently includes:

Support for Quality Improvement

Medicare Beneficiary Quality Improvement Program (MBQIP)

The Medicare Beneficiary Quality Improvement Program (MBQIP) is the primary source for demonstrating the quality of care provided by CAHs on a national level. All of Oregon's CAHs participate in MBQIP. ORH offers technical assistance to CAHs in reporting and quality related activities relating to MBQIP measures. Visit the ORH MBQIP page for additional resources and activities.

Quality Improvement Support

ORH has developed a Critical Access Hospital Quality Reporting Overview Guide to assist new and experienced Quality Officers with reporting requirements at their CAH. 

The ORH MBQIP Benchmarking Program encourages peer-to-peer 21 of Oregon CAHs participate in this program. The program allows CAHs to select one or more CAHs that are similar in size, volume or demographics to benchmark with. The goal of the benchmarking report is to provide CAHs with the opportunity to not only compare MBQIP and HCAHPS results, but to network and share best practices with each other. By benchmarking, CAHs can work together to share stories of what has and has not worked for reporting as well as quality improvement efforts and workflows. To view samples of available reports, click here.

In partnership with HealthInsight of Oregon, ORH offers regular Peer-to-Peer Round Table calls to CAH Quality Officers and staff. In addition to presenting an educational component, the Round Tables provide a peer-to-peer learning and networking opportunity for quality staff. Contact Stacie Rothwell, Field Services Program Manager at if you are interested in participating in the next call.

ORH, in partnership with HealthInsight of Oregon is also offering individual, onsite CAH TeamSTEPPS training under the Small Hospital Improvement Project (SHIP) grant during the 2017-18 grant cycle. For more information about this program, or if your CAH is interested in participating in a similar program for future grant cycles, contact Rebecca Dobert, Program Coordinator at ORH at .

Oregon Critical Access Hospital Reports

The Flex Monitoring Team (FMT) is a consortium of the Rural Health Research Centers in Minnesota, North Carolina, and Maine. FMT evaluates the impact of the Medicare Rural Hospital Flexibility Grant Program (Flex). Part of the work they do focuses on the quality performance of CAHs which includes tracking CAH participation in MBQIP and producing annual quality reports for each state. The FMT Quality Reports released in 2017 are below:

Hospital Compare Quality Measure Results for Oregon CAHs: 2015 (released February 2017)

Patients' Experiences in Oregon CAHs - HCAHPS Results: 2015 (released January 2017)

Support for Financial and Operational Improvement

Board and Leadership Development

Flex supports board and leadership training for CAHs. For more information on on-site consultations and workshops, please contact Meredith Guardino | | 503-494-4450 | toll-free 866-674-4376.

The Rural Health Reform Initiative

ORH supports OAHHS’ Rural Health Reform Initiative to preserve access to local health care services for rural Oregonians. The RHRI focuses on sustainable state and federal funding for type A/B hospitals and health systems through new models of care delivery and reimbursement.

Support for Health System Development and Community Engagement

Community Engagement Grants

The Oregon Office of Rural Health awarded $117,000 in Community Engagement Grants during FY 2014-15 to five Critical Access Hospital communities across Oregon. Using Health Resources and Services Administration Rural Hospital Flexibility Grant funds, these grants enabled hospitals and their communities to implement sustainable programs in response to challenges identified by community needs assessments ranging from nutrition to mental health.

EMS Training and Continuing Education

EMS/Trauma Webinars is a partnership between the Oregon Office of Rural Health and the Oregon EMS and Trauma Systems. Presentations will last approximately one hour and will be recorded for those who cannot attend the live presentation. Continuing Education (CE) credits will be available for those who are able to attend the live presentation. ORH also sponsors the Spring EMS Forum will be held May 28-29, 2015 in Hood River. More information will available closer to the date, including scholarship guidelines for rural attendees.


For any questions on the Flex program or the current grant year activities, please contact: Meredith Guardino | | 503-494-4450 | toll-free 866-674-4376.