Opportunity Information: Apply for HRSA 24 002
The Medicare Rural Hospital Flexibility (Flex) Program is a federal funding opportunity from the Health Resources and Services Administration (HRSA) designed to strengthen rural health care by helping states support Critical Access Hospitals (CAHs) and rural emergency medical services (EMS). At its core, the program funds state-led efforts to improve how rural hospitals and EMS systems measure quality, report performance, learn from benchmarking, and carry out practical improvement work. It also supports rural hospitals that are seeking to become designated as CAHs, recognizing that CAH status can be a key tool for sustaining access to hospital care in rural communities.
The overall aim is to make sure rural communities have access to high-quality health care that matches local needs, spanning the full continuum of care. That includes preventive and outpatient services, pre-hospital and emergency response, and inpatient care when needed. HRSA frames the end goal as building a rural health system that delivers high value, improves patient outcomes, and contributes to healthier rural populations over time. Rather than focusing on one-off projects, the Flex Program emphasizes training, technical assistance, capacity-building, and sustainable improvements that states can carry forward.
The program lays out long-term objectives for both CAHs (including CAH-owned clinics) and rural EMS agencies. These objectives include demonstrating and improving quality of care, stabilizing finances while maintaining essential services, adapting to changing community health needs, and integrating patient care across the rural delivery system so patients experience more coordinated care. The notice also highlights that the health care environment is shifting quickly toward value-based care and alternative payment models, and it encourages states to pursue innovative care models when they fit local circumstances.
State Flex funding is organized around five program areas, with clear expectations about what is required versus optional. Program Area 1, CAH Quality Improvement, is required and focuses on helping CAHs improve clinical quality, measurement, reporting, and performance improvement practices. Program Area 2, CAH Financial and Operational Improvement, is also required and targets hospital sustainability through stronger financial practices, operational efficiency, and management strategies that help CAHs remain viable while continuing to serve rural residents. Program Area 3, CAH Population Health Improvement, is optional and supports strategies that improve community health outcomes and address population-level needs. Program Area 4, Rural EMS Improvement, is optional and supports efforts to establish, expand, or improve rural EMS systems, recognizing the outsized role EMS plays in rural access and outcomes. Program Area 5, CAH Designation, is required if a state is requesting funds to assist rural hospitals that are seeking CAH designation, supporting the steps needed for conversion and readiness.
Eligibility is limited to states, including those already receiving Flex awards and those applying through a newly submitted application. HRSA will accept only one application per state, and the applicant organization must be designated by the Governor to apply on the state’s behalf, which positions the program as a statewide coordinating resource and focal point rather than a collection of separate local applications. The opportunity is offered as a cooperative agreement, meaning HRSA expects substantial involvement and partnership during the project period. The funding opportunity number is HRSA-24-002 (CFDA 93.241), with an original closing date of April 16, 2024, and an expected total of 45 awards. The notice lists an award ceiling of 0, which typically signals that applicants should rely on the official funding announcement details and related guidance for any limits or funding parameters rather than assuming a fixed maximum from the summary field alone.Apply for HRSA 24 002
- The Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Medicare Rural Hospital Flexibility Program" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.241.
- This funding opportunity was created on 2024-01-17.
- Applicants must submit their applications by 2024-04-16. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The number of recipients for this funding is limited to 45 candidate(s).
- Eligible applicants include: State governments, Others.
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Medicare Rural Hospital Flexibility (Flex) Program (HRSA) - FAQs
What is the Medicare Rural Hospital Flexibility (Flex) Program?
The Medicare Rural Hospital Flexibility (Flex) Program is a federal funding opportunity from the Health Resources and Services Administration (HRSA) that is designed to strengthen rural health care. It does this by funding state-led efforts that support Critical Access Hospitals (CAHs) and rural emergency medical services (EMS).
What is the main purpose of this funding opportunity?
The core purpose is to help states improve how rural hospitals and EMS systems measure quality, report performance, learn from benchmarking, and carry out practical improvement work. The program also supports rural hospitals seeking to become designated as CAHs when a state requests that specific support.
Who is the program intended to benefit?
The program is structured around statewide efforts that ultimately benefit rural communities by supporting CAHs (including CAH-owned clinics) and rural EMS agencies. The end goal is improved access to high-quality health care that matches local needs across the continuum of care.
What does HRSA mean by the "continuum of care" in this program?
In this notice, the continuum of care includes preventive and outpatient services, pre-hospital and emergency response, and inpatient care when needed. The program is aimed at supporting coordinated rural systems rather than isolated service improvements.
What types of activities does the Flex Program emphasize?
The Flex Program emphasizes training, technical assistance, capacity-building, and sustainable improvements that states can carry forward. It is framed as a long-term systems strengthening effort rather than a one-time project model.
What long-term objectives does the program identify for CAHs and rural EMS?
The notice describes long-term objectives that include demonstrating and improving quality of care, stabilizing finances while maintaining essential services, adapting to changing community health needs, and integrating patient care across the rural delivery system so patients experience more coordinated care.
How does the program relate to value-based care and alternative payment models?
The notice highlights that the health care environment is shifting toward value-based care and alternative payment models. It encourages states to pursue innovative care models when they fit local circumstances.
How is the state Flex funding organized?
State Flex funding is organized around five program areas. The notice distinguishes between program areas that are required and those that are optional, with clear expectations about what must be included versus what may be included depending on a state's priorities and application approach.
Which program areas are required?
Program Area 1 (CAH Quality Improvement) is required. Program Area 2 (CAH Financial and Operational Improvement) is required. Program Area 5 (CAH Designation) is required only if a state is requesting funds to assist rural hospitals seeking CAH designation.
What is Program Area 1: CAH Quality Improvement?
Program Area 1 is required and focuses on helping CAHs improve clinical quality, measurement, reporting, and performance improvement practices.
What is Program Area 2: CAH Financial and Operational Improvement?
Program Area 2 is required and targets hospital sustainability through stronger financial practices, operational efficiency, and management strategies that help CAHs remain viable while continuing to serve rural residents.
What is Program Area 3: CAH Population Health Improvement?
Program Area 3 is optional and supports strategies that improve community health outcomes and address population-level needs.
What is Program Area 4: Rural EMS Improvement?
Program Area 4 is optional and supports efforts to establish, expand, or improve rural EMS systems, reflecting the important role EMS plays in rural access and outcomes.
What is Program Area 5: CAH Designation?
Program Area 5 supports steps needed for conversion and readiness for rural hospitals seeking CAH designation. It is required only if a state is requesting funds for this purpose.
Does the program support hospitals that want to become Critical Access Hospitals (CAHs)?
Yes. The opportunity states that it supports rural hospitals seeking CAH designation, and it includes a specific required program area (Program Area 5) when a state requests funds to assist hospitals pursuing CAH status.
Who is eligible to apply for this funding?
Eligibility is limited to states. This includes states already receiving Flex awards as well as states applying through a newly submitted application.
Can multiple organizations within a state apply separately?
No. HRSA will accept only one application per state, which positions the program as a statewide coordinating resource rather than a collection of separate local applications.
Who must submit the state application?
The applicant organization must be designated by the Governor to apply on the state's behalf.
What type of award mechanism is used?
The opportunity is offered as a cooperative agreement. This means HRSA expects substantial involvement and partnership during the project period.
What is the funding opportunity number and CFDA number for this program?
The funding opportunity number is HRSA-24-002 and the CFDA number is 93.241.
What was the original closing date listed for the opportunity?
The original closing date listed in the notice is April 16, 2024.
How many awards does HRSA expect to make?
The notice indicates an expected total of 45 awards.
Is there a stated maximum award amount (award ceiling)?
The notice lists an award ceiling of 0. This typically indicates that applicants should rely on the official funding announcement details and related guidance for any limits or funding parameters rather than assuming a fixed maximum from the summary field alone.
Is this grant focused on one-off projects or longer-term system improvements?
The program is framed around sustainable improvements, capacity-building, and ongoing training and technical assistance, with the end goal of strengthening rural health systems over time.
Does the program focus only on hospitals?
No. While CAHs are a central focus, the program also supports rural EMS improvement (as an optional program area) and emphasizes coordinated care across the rural health delivery system.
What outcomes is HRSA ultimately aiming for through the Flex Program?
HRSA frames the end goal as building a rural health system that delivers high value, improves patient outcomes, and contributes to healthier rural populations over time, while ensuring rural communities have access to care that matches local needs.
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| Maternal and Child Health Policy Innovation Program Apply for HRSA 24 037 Funding Number: HRSA 24 037 Agency: Health Resources and Services Administration Category: Health Funding Amount: $400,000 |
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| Poison Control Centers Program Apply for HRSA 24 045 Funding Number: HRSA 24 045 Agency: Health Resources and Services Administration Category: Health Funding Amount: Case Dependent |
| Autism Field-Initiated Innovative Research Studies (Autism FIRST) Apply for HRSA 24 048 Funding Number: HRSA 24 048 Agency: Health Resources and Services Administration Category: Health Funding Amount: $300,000 |
| State Maternal Health Innovation Apply for HRSA 24 047 Funding Number: HRSA 24 047 Agency: Health Resources and Services Administration Category: Health Funding Amount: Case Dependent |
| National Coordinating Center on Transition Apply for HRSA 24 041 Funding Number: HRSA 24 041 Agency: Health Resources and Services Administration Category: Health Funding Amount: $735,000 |
| Transition for Youth with Autism and/or Epilepsy Demonstration Projects Apply for HRSA 24 042 Funding Number: HRSA 24 042 Agency: Health Resources and Services Administration Category: Health Funding Amount: $450,000 |
| Cooperative Newborn Screening System Priorities Program (NBS Co-Propel) Apply for HRSA 24 052 Funding Number: HRSA 24 052 Agency: Health Resources and Services Administration Category: Health Funding Amount: $500,000 |
| Maternal Health Training and Resource Center (MHTRC) Apply for HRSA 24 050 Funding Number: HRSA 24 050 Agency: Health Resources and Services Administration Category: Health Funding Amount: $3,000,000 |
| Community Level Innovations for Improving Health Outcomes Apply for MP CPI 24 001 Funding Number: MP CPI 24 001 Agency: Office of the Assistant Secretary for Health Category: Health Funding Amount: $600,000 |
| Expanding Outreach and Professional Training to Engage Older Adults with Behavioral Health Conditions in Evidence-Based Health Promotion Programs Apply for HHS 2024 ACL AOA CSSG 0018 Funding Number: HHS 2024 ACL AOA CSSG 0018 Agency: Administration for Community Living Category: Health Funding Amount: $3,260,699 |
| Community Opioid Intervention Prevention Program Apply for HHS 2024 IHS COIPP 0001 Funding Number: HHS 2024 IHS COIPP 0001 Agency: Indian Health Service Category: Health Funding Amount: $500,000 |
| National Urban Indian Behavioral Health Awareness Apply for HHS 2024 IHS NUIBH 0001 Funding Number: HHS 2024 IHS NUIBH 0001 Agency: Indian Health Service Category: Health Funding Amount: $75,000 |
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