Assistance program
State Rural Hospital Flexibility Program
$186.7 Million committed in FY2018–FY2026
- Agency
- Health Resources and Services Administration, Health and Human Services, Department of
- Assistance
- Project Grants
- CFDA number
- 93.241
- What it does
- The Rural Hospital Flexibility Program (Flex) enables state designated entities to support critical access hospitals in quality improvement, quality reporting, performance improvement, and benchmarking; to assist facilities seeking designation as critical access hospitals; and to create a program to establish or expand the provision of rural emergency medical services. Flex Program objectives include quality, operational, financial, and population health improvement with the goal of supporting access to necessary health care services in rural communities. State Flex programs will act as resources and focal points for these activities within their respective states. The Rural Veterans Health Access Program provides funding to states to coordinate activities to provide rural veterans access to services for needed mental health care via the use of networks, electronic communication and telehealth networks. The program targets states with high percentages of veterans to the total population.
- Who benefits
- States with at least one hospital located in a non-metropolitan statistical area or county that provide CMS with necessary assurances.
- Who applies
- Flex and Rural Veterans Recipients: Only states with certified Critical Access Hospitals are eligible for this Program. The Governor designates the eligible applicant from each state. All other states need to submit an application to the Regional Administrator of their CMS Regional Office that expresses the state's interest in developing a Medicare Rural Hospital Flexibility Program before they can apply for funds.
- Authorized by
- The Rural Veterans Health Access Program-Title XVIII, § 1820 (g) (6) of the Social Security Act (42 U.S.C. 1395i-4(g) (6)), as amended
- The Rural Hospital Flexibility Program (Flex)-Title XVIII, §1820(g) (1) and (2) of the Social Security Act (42 U.S.C. 1395i-4), as amended
- Program site
- http://www.hrsa.gov/ruralhealth/ ↗
Committed by fiscal year
* FY2026 is year-to-date — the fiscal year is still in progress, so its total is still filling in. The striped band and dashed line mark that provisional stretch.
Top recipients
By dollars committed.
How to read these numbers
- Committed through this program
Money committed under this assistance listing (its CFDA program), counted in the year each action happened.
- How it's paid
Most programs pay out one way — a grant, or a direct payment to individuals; the flow bar only appears when a program genuinely mixes types.
- Some recipients aren't itemized
For entitlement programs like Social Security and Medicare, the government reports one aggregate instead of naming tens of millions of people, so the recipient roster isn't part of the public record.
- Awards, counted once
An award count is the number of distinct awards with at least one action that year — each counted once, however many times it was amended.
- The colored bars
Every bar on this page splits by how the money moves:
Direct payments