Medicare Rural Hospital Flexibility Program

The Kansas Rural Health Options Project (KRHOP) administers the Medicare Rural Hospital Flexibility (FLEX) Program in the state of Kansas. The FLEX Program is a federally-funded initiative that provides funding to state governments to strengthen rural health. The program is administered by the Office of Rural Health Policy (ORHP) in the Health Resources and Services Administration. The FLEX program was created by the Balanced Budget Act of 1997.  It replaced a pilot program, the Essential Access Hospital/Rural Primary Care Hospital Program (EACH/RPCH) that was implemented in Kansas and seven other states.  The Kansas EACH/RPCH Program was selected as the nation’s Outstanding Rural Health Program in 1995 by the National Rural Health Association. The goals of the FLEX program are to:

  • Allow small hospitals the flexibility to reconfigure operations and be licensed as Critical Access Hospitals (CAHs);
  • Offer cost-based reimbursement from CMS for acute inpatient and outpatient services provided to Medicare beneficiaries by CAHs;
  • Encourage the development of rural-based health networks;
  • Offer grants to states to help implement a FLEX program in the context of broader initiatives to strengthen the rural health care infrastructure.

The Kansas Rural Health Options Project is a partnership of

Within this functional collaboration, each partner brings specific strengths to the administration of the program. As the state organization housing both the Bureau of Community Health Systems (BCHS) and the Bureau of Child Care and Health Facilities (BCCHF), the Kansas Department of Health and Environment contributes a link to state policy and the regulatory process. BLRH, the state’s chief rural health policy agency, administers all FLEX Program grant funds and coordinates network development, the designation of CAHs, EMS, quality improvement, and other program activities. BCCHF is the state agency responsible for surveying, licensing, and certifying health care providers. Healthworks is a not-for-profit subsidiary of the Kansas Hospital Association (KHA), providing research, education, and policy support to KHA and the state’s hospitals. KHA has a membership of 125 community hospitals and provides direct contact with hospitals interested or already participating in the program, maintaining linkages to provide advocacy, education, and technical assistance. The Kansas Board of EMS is the state agency that guides policy and regulation of the state’s 180 local EMS services and the Kansas Medical Society (KMS) represents physicians in the state.

KRHOP Project Opportunities

To learn more about the project opportunities offered through the KRHOP, click here.