Of the 164 licensed hospitals in Missouri, 72 (45 percent) are located in rural areas. Of those 72 hospitals, nearly half (36) are Critical Access Hospitals which have 25 beds or less and provide a limited scope of service.

The CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. This is accomplished through cost-based Medicare reimbursement (see What are the benefits of CAH status?).

The Flex Program supports Critical Access Hospitals (CAHs) to promote quality and performance improvement including:  Stabilizing finances; Integrating emergency medical services into health care systems; Incorporating population health; and Fostering innovative models of health care.

Under the Flex Program, the Medicare Beneficiary Quality Improvement Project seeks to improve the quality of care provided in CAHs by voluntarily reporting measures not required by CMS.  States coordinate technical assistance based on the needs of hospitals in their state. Hospitals interested in participating in the Flex Program should contact their MO State Office of Rural Health to determine eligibility.

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