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:

The Medicare Rural Hospital Flexibility (Flex) Grant Program – The Flex program is 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 purpose of this cooperative agreement is to enable state Flex programs to support critical access hospitals (CAHs) in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as CAHs; and to create a program to establish or expand the provision of rural emergency medical services (EMS).

The aim of the Flex Program is to provide training and technical assistance to build capacity, support innovation, and promote sustainable improvement in the rural health care system. The overall goal of the Flex Program is to ensure that high quality health care is available in rural communities and aligned with community needs. Health care services include appropriate preventative, ambulatory, pre-hospital, emergent, and inpatient care. High quality rural health care will deliver high value to patients and communities and result in healthier rural people.
The long-term objectives of the Flex Program are to enable CAHs, including CAH-owned clinics, and rural EMS agencies to:

• Show and improve quality of care;
• Stabilize finances and maintain services;
• Adjust to address changing community needs; and
• Ensure patient care is integrated throughout the rural health care delivery system.

State Flex funding acts as a resource and focal point to address needs and demonstrate outcomes in the following six program areas with an emphasis and priority on quality, operational, and financial improvement in CAHs:

Program Area 1: CAH Quality Improvement (required)
Program Area 2: CAH Operational and Financial Improvement (required)
Program Area 3: CAH Population Health Improvement (optional)
Program Area 4: Rural EMS Improvement (optional)
Program Area 5: Innovative Model Development (optional)
Program Area 6: CAH Designation (required if assistance is requested by rural hospitals)

Currently, the Flex Program supports 30 critical access hospitals in Georgia.

Small Rural Hospital Improvement Program (SHIP) Grant – The SHIP Program is also a cooperative agreement funded by the HRSA FORHP. SHIP provides support to Georgia’s 54 eligible small rural and critical access hospitals in meeting value-based payment and care goals for their respective organizations, through purchases of hardware, software, and training. SHIP also enables small rural hospitals to:

• Become or join accountable care organizations (ACOs); 
• Participate in shared savings programs; and 
• Purchase health information technology (hardware and software), equipment, and/or training to comply with quality improvement activities, such as advancing patient care information, promoting interoperability, and payment bundling.

SHIP funds assist eligible small rural hospitals that are essential access points for Medicare and Medicaid beneficiaries. Eligible small rural hospitals are non-federal, short-term general acute care facilities that are located in a rural area of the U.S. and the territories, including faith-based hospitals. SHIP hospitals must certify they operate with 49 staffed beds or less.

Other Rural Grant Opportunities – The Hospital Services Program also develops and provides oversight to other innovative state funded and legislatively directed 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 30 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