Rural Hospital Services

The Georgia State Office of Rural Health’s Hospital Services Program provides technical assistance and resources to support Critical Access and small rural hospitals in improving health care access, quality and cost-effectiveness for all Georgians. 
The initiatives include:

Medicare Rural Hospital Flexibility (Flex) Grant Program – Funded by the U.S. Department of Health and Human Services, Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy (FORHP), the Flex Program encourages the development of cooperative systems of care in rural areas, joining together Critical Access Hospitals (CAHs), Emergency Medical Service (EMS) providers, clinics and health practitioners to increase efficiencies and quality of care. The Flex Program requires states to develop rural health plans and funds their efforts to implement community-level outreach. The Flex Program provides support for CAHs in five program areas including:

  • Quality Improvement -including the Medicare Beneficiary Quality Improvement Program (MBQIP)
  • Financial and Operational Improvement
  • Population health management and EMS integration (optional)
  • Designation of CAHs (required if requested)
  • Integration and innovative health care models (optional)

Small Rural Hospital Improvement Program (SHIP) Grant – The SHIP Program is also funded by the HRSA FORHP and assists eligible small rural hospitals in meeting the costs of implementing data system requirements established under the Medicare Program, including funds to assist hospitals in participating in improvements in value and quality to health care such as:

  • Value Based Purchasing Programs (VBP) – VBP programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. Part of a larger quality strategy to reform how health care is delivered, VBP supports the three-part aim of:
    • Better Care for Individuals
    • Better health for populations
    • Lower Cost
  • Accountable Care Organizations (ACOs) or Shared Savings Investment activities – ACOs are groups of clinicians, hospitals, and other health care providers that choose to come together to deliver coordinated, high-quality care at a lower cost to the Medicare patients they serve. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care.
  • Payment Bundling (PB) or Prospective Payment Systems (PPS) programs - The PB/PPS program supports initiatives for innovative payment and service delivery models that have potential to reduce Medicare, Medicaid or Children’s Health Insurance Program expenditures while preserving or enhancing the quality of care for beneficiaries.

The SHIP Program encourages eligible hospitals to form networks and pool grant funds to maximize purchasing power through economies of scale.

Other Rural Grant Opportunities – The Hospital Services Program also develops and provides oversight to other innovative state funded and legislatively mandated grants as needs are identified and funding becomes available. These projects share the common goal of providing access or improving health care in Georgia’s underserved rural areas.

Critical Access Hospital Program – The Critical Access Hospital (CAH) designation is given to eligible rural hospitals by the Centers for Medicare and Medicaid Services (CMS). Currently there are 31 designated CAHs in Georgia. 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. To accomplish this goal, CAHs receive certain benefits, such as cost-based reimbursement for Medicare services. They are structured differently than other small rural hospitals and must meet certain criteria including:

  • Are certified for no more than 25 beds
  • Maintain an average annual length of stay of 96 hours
  • Offer 24-hour, 7-day-a-week emergency care
  • Located in a designated rural area, with at least a 35-mile drive from another hospital