Flex Program Information
The Balanced Budget Act of 1997 established the Medicare Rural Hospital Flexibility Program (Flex), creating the Critical Access Hospital (CAH) as a new Medicare provider type eligible for cost-based reimbursement. The Flex Program provides funding to the States to assist in the designation of Critical Access Hospitals and the development of rural networks to improve access to care. This program is based on the experiences of demonstration projects from the early 1990s where States developed networks of limited-service hospitals and other providers to improve access to care in rural areas. The Flex Program makes it possible for Wisconsin to provide technical assistance to hospitals interested in obtaining CAH status, and to assist in the application and certification process, including the hospital survey.
Each state is required to develop a rural health plan that provides the guiding principles of implementing the statewide conversion of hospitals to CAH status. The Wisconsin Rural Health Plan was developed based upon the recommendations of a Critical Access Hospital Coalition. The Coalition is comprised of representatives from CAH hospitals and applicants, Wisconsin Department of Health Services (DHS), the Wisconsin Office of Rural Health (WI-ORH), Wisconsin Hospital Association (WHA), and the Rural Wisconsin Health Cooperative (RWHC).
As of August 2007, Wisconsin has 58 CAHs, far above the national average of 28.5 CAHs per state. In its first years of operation, the Wisconsin Flex Program directed the majority of its federal funding to assist small rural hospitals with their conversion to CAH status and to support and sustain small rural hospitals. Now that all eligible hospitals have converted to CAH status (Few to no small rural hospitals continue to be eligible for CAH status in the state.), funds have now been allocated to support Critical Access Hospitals, Rural Health Clinics and Rural EMS Providers in the areas of:
- Quality Improvement
- Financial & Operational Improvement
- Health Information Technology
- Network development
- Health promotion/disease prevention activities
- Education and Training
- Technical Assistance with regulations, reimbursement and relocation