# State Rural Hospital Flexibility Program (93.241)

Source: https://welltoldgrants.com/programs/93-241-state-rural-hospital-flexibility-program/  
Publisher: Well Told Grants. Data: USAspending.gov and Grants.gov, updated October 31, 2026.

State Rural Hospital Flexibility Program is run by Department of Health and Human Services. From fiscal 2021 to 2025 it awarded $92.7 million in 58 grants, about $1.6 million per award.

## Objectives

The Medicare 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. The 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 initiative 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. The Medicare Rural Hospital Flexibility Program Evaluation Cooperative Agreement improves healthcare in rural areas by analyzing Critical Access Hospital (CAH) data, capturing best practices, and targeting limited CAH resources. The Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement provides TA, capacity building and support to the Medicare Rural Hospital Flexibility Program and the Small Rural Hospital Improvement Program. The Rural Quality Improvement Technical Assistance Cooperative Agreement provides TA to FORHP recipients, Critical Access Hospitals (CAHs), and other rural providers, using data to demonstrate improvement in quality of care for rural patients

## Funding by fiscal year

| Year | Amount | Awards |
|---|---|---|
| 2021 | -$641 | 0 |
| 2022 | $4.9 million | 48 |
| 2023 | $5.0 million | 2 |
| 2024 | $41.5 million | 55 |
| 2025 | $41.3 million | 53 |

## Largest recipients

| Recipient | State | Amount |
|---|---|---|
| Rural Health Redesign Center Organization, Inc. | Pennsylvania | $17.4 million |
| Rural Health Resource Center | Minnesota | $3.9 million |
| Regents of the University of Minnesota | Minnesota | $3.5 million |
| Michigan Center for Rural Health | Michigan | $2.6 million |
| State of Montana Department of Health and Human Services | Montana | $2.4 million |
| Kansas Department of Health & Environment | Kansas | $2.2 million |
| Oregon Health & Science University | Oregon | $2.2 million |
| Texas Department of Agriculture | Texas | $2.2 million |
| Washington State Department of Health | Washington | $2.1 million |
| Ohio Department of Health | Ohio | $2.1 million |
| Minnesota Department of Health | Minnesota | $2.1 million |
| University of North Dakota | North Dakota | $2.0 million |
| Nebraska Department of Health & Human Services | Nebraska | $2.0 million |
| Oklahoma State University | Oklahoma | $1.9 million |
| Department of Public Health Illinois | Illinois | $1.9 million |
| University of Wisconsin System | Wisconsin | $1.8 million |
| Iowa Department of Public Health | Iowa | $1.8 million |
| Maine Department of Health and Human Services | Maine | $1.8 million |
| University of Arizona | Arizona | $1.8 million |
| Board of Regents of Nevada System of Higher Education | Nevada | $1.7 million |