Alaska Rural Hospital Flexibility Program

Program Purpose

The Balanced Budget Act of 1997 created the Medicare Rural Hospital Flexibility Program. The purpose of the program is to assist rural hospitals to improve access to health services in rural communities, to improve quality and relieve some of the financial pressures on rural hospitals and emergency medical services.

Program Mission

The focus of Alaska’s Flex Program is supporting rural systems of care with emphasis on Critical Access Hospitals in rural Alaska.

The Flex Program provides support and assistance by:

  • Providing financial assistance to rural hospitals through grants and other programs
  • Offering information, training, and technical assistance on topics related to CAH operations
  • Acting as the liaison between communities and federal and state programs
  • Providing related program planning and research
  • Implementing program enhancements
  • Monitoring and communicating changes in federal programs
  • Evaluating program performance

Other elements of the Flex Program

  • Emergency Medical Services trauma level designation for Emergency Departments: Flex Program funds help to support trauma level designations of Emergency Departments in small rural hospitals. Trauma level designation is important for reimbursement issues.
  • Quality and Performance Improvement:Small rural hospitals often lack the capacity and resources to pursue organized quality improvement initiatives. Flex funding promotes optimum care, improves patient health and safety, and promotes and preserves local access to care.
  • Promoting Networks and Community Development:Many rural hospitals cannot support a full range of specialty and high tech services. Well-organized networks can promote system efficiency, help hospitals maintain their census and maintain compliance with CAH rules.

Critical Access Hospital Designation Process

Critical Access Hospital designation under the Medicare Rural Hospital Flexibility Program requires that a hospital first be designated and then licensed by the State and certified by the federal government.

The Process

  • A provider requests certification.
  • An on-site survey is conducted by Health Facilities Licensing and Certification staff to determine if the facility meets applicable State and Federal law and regulations.
  • If requirements are met, the facility is licensed and certified to provide health care services.
  • The State Rural Hospital Flexibility Program requires a designation that the hospital is eligible to participate in the program and convert to a Critical Access Hospital.



Tricia Franklin
phone: 907-269-3445

Cate Harmon
phone: 907-269-0036