Publications

The Flex Monitoring Team completes projects each year in a variety of topic areas such as CAH financial and operational improvement, patient safety, quality of care, Emergency Medical Services, and social determinants of health. These publications aim to evaluate the Flex Program and disseminate information to State Flex Programs, CAHs, and the general public. Our publications offer a wide range of information about Flex Program activities, best practices in CAHs, financial, quality, and community measures, and hospital services. Below is a list of publications from the Flex Monitoring Team. Publications are listed chronologically, in descending order. You can search by title and filter by topics and state. For data reports and publications relevant to specific states, please visit our State Profiles.

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Kristin L. Reiter
This Data Summary Report presents state and national median values of the 23 financial indicators included in the Critical Access Hospital…
John Gale, Karen Pearson, Sara Kahn-Troster
The Flex Monitoring Team is conducting a multi-year evaluation of the Flex Program's Emergency Medical Services (EMS) Supplemental funding grant,…
John Gale, Celia Jewell, Sara Kahn-Troster, Zach Croll
The Medicare Rural Hospital Flexibility (Flex) Program funds initiatives to improve the health of rural communities under Program Area 3: Population…
Celia Jewell, Sara Kahn-Troster, Zach Croll, John Gale
This brief responds to interest from State Flex Programs (SFPs) and other Critical Access Hospital (CAH) stakeholders about the range of population…
John Gale, Sara Kahn-Troster, Zach Croll
This brief provides a detailed look at outcome measurement issues for State Flex Program (SFP) interventions conducted under Program Area 2:…
Ira Moscovice, Madeleine Pick, Megan Lahr
This report presents data on the initial response to COVID-19 in system-affiliated and independent Critical Access Hospitals (CAHs). Data in this…
Megan Lahr, Nathan Bean, Ira Moscovice
This report summarizes reporting rates and performance among U.S. Critical Access Hospitals (CAHs) on Medicare Beneficiary Quality Improvement…
Ira Moscovice, Madeleine Pick, Megan Lahr, Nathan Bean, Keelia Silvis
The COVID-19 pandemic has heightened the financial and operational pressures on small rural hospitals, including Critical Access Hospitals (CAHs).…
Megan Lahr, Tongtan Chantarat, Mariah Quick, Madeleine Pick, Ira Moscovice
This brief summarizes characteristics of Critical Access Hospital initiatives addressing the social needs of individuals in their communities.…
Laura Bozovich, Kathleen Knocke, George Pink, Ann Howard, Kristin L. Reiter
There is growing evidence to suggest that affiliation with a health system may have important implications for rural hospitals. However, most studies…