A rural hospital designation established by the Medicare Rural Hospital Flexibility Program (MRHFP) enacted as part of the 1997 Balanced Budget Act. Designated hospitals are reimbursed based on cost (rather than prospective payment), must comply with federal and state regulations for CAHs, and are exempt from certain hospital staffing requirements.
Deeper dive
Rural hospitals meeting criteria established by their state may apply for critical access hospital status. According to the National Rural Health Resource Center, the Medicare Rural Hospital Flexibility Program (Flex Program) encourages development of cooperative systems of care in rural areas, joining together 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 includes support for the following five program areas:
● CAH Quality Improvement (required).
● CAH Operational and Financial Improvement (required).
● CAH Population Health Improvement (optional).
● Rural Emergency Medical Services (EMS) Improvement (optional).
● Rural Innovative Model Development (optional).
● CAH Designation (required if requested).
The National Rural Health Resource Center and the Federal Office of Rural Health Policy (FORHP) established The Critical Access Hospital (CAH) Recognition certificate to recognize the excellent work in CAHs throughout the country. You can find a list of those facilities on the NRHRC site.