Rural Hospitals (Flex Program)


An Interim Evaluation Report of the Innovative Projects Portfolio of the Flex Program (FMT Briefing Paper #37)

Document Type

Briefing Paper

Publication Date



Rural, Flex Program, hospitals, innovation, Critical Access hospitals, MRHRC, rural hospitals, telehealth, care coordination, quality improvement


In the most recent competitive grant cycle (FY2015-17), the Flex Program included an optional new program area focused on rural health system innovations—Program Area 5: Integration of Innovative Health Care Models (Innovative Projects)—to address needs not covered by the other core areas of the grant program. The Flex Monitoring Team (FMT) has undertaken an evaluation of the states participating in this new program area, with a particular focus on activities involving the transition to value-based care, telehealth, care coordination, quality improvement, and system delivery in rural communities. This report provides background on the Flex Program and the Innovative Projects program area. With a focus on the projects and implementation experiences of seven states participating in the Flex Monitoring Team evaluation, we describe the states’ projects and desired outcomes, and discuss initial evaluation observations.


For more information on this study, please contact Sara Kahn-Troster at

Funding Organization

Federal Office of Rural Health Policy

Grant Number

PHS Grant No. U27RH01080