Population Health Strategies of CAHs (FMT Briefing Paper #36)

Document Type

Briefing Paper

Publication Date



Rural Hospitals (Flex Program), population health, critical access hospitals, rural, MRHRC, Cutler Institute


Hospitals and health systems, including those serving rural communities, are increasingly embracing population health strategies as they move toward accountable care models of health care delivery and financing and seek to re-focus their community benefit activities to improve the overall health of their communities, demonstrating their accountability to local stakeholders. This paper provides examples of eight CAHs and communities that have made substantial commitments to population health and community health improvement. Key themes that emerged from the qualitative interviews of the selected CAHs highlight the collaborative nature and the high level of community involvement of the various initiatives.


The Medicare Rural Hospital Flexibility Program (Flex Program) was created by Congress in 1997, allowing small hospitals to be certified as Critical Access Hospitals (CAHs) and offering grants to States to help implement initiatives to strengthen the rural health care infrastructure. The Flex Program is administered by the Federal Office of Rural Health Policy within the Health Resources Service Administration, US Department of Health and Human Services. The Flex Monitoring Team, which conducts research and evaluation on Flex Program activities, is a consortium of the Rural Health Research Centers at the University of Southern Maine, University of North Carolina-Chapel Hill, and the University of Minnesota.

Funding Organization

Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS)

Grant Number


bp36.pdf (429 kB)
Population Health Strategies of CAHs (FMT Briefing Paper #36)