Of the 161 licensed hospitals in Missouri, 67 (42%), including five (5) behavioral health hospitals, are located in rural counties. Of those 67 hospitals, 62 are hospitals with medical/surgical beds, five (5) are behavioral health hospitals, 31 are Critical Access Hospitals (CAHs), which have 25 beds or less and provide a limited scope of service. The additional four (4) CAHs are located in non-rural counties.

The Critical Access Hospitals designation is given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS) 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.

The Medicare Rural Hospital Flexibility (Flex) Program supports the 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 (MBQIP) focuses on improving the quality of care provided in CAHs by voluntarily reporting measures not required by CMS. The Missouri FLEX program coordinates technical assistance based on the needs of the Missouri hospitals. Hospitals interested in participating in the Flex Program should contact the MO State Office of Rural Health to determine eligibility.

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