Medicare Rural Hospital Flexibility Grant Program: Kentucky Rural Health Works Program

Grants and Contracts Details


The Kentucky Rural Hospital Flexibility Program (KRHFP/Flex) is under the auspice of the Kentucky State Office of Rural Health (KSORH), which is housed within the University of Kentucky Center of Excellence for Rural Health (UK CERN) located in Hazard, a rural area in the Appalachian Mountains of southeastern Kentucky. The vision of the KRHFP is to help sustain access to appropriate healthcare services of high qualify in rural communities by strengthening and improving the rural healthcare infrastructure. Since the inception of the Flex Program in 1999, the KSORH and the KRHFP have partnered with the Kentucky Hospital Association and together they hold annual statewide stakeholders meetings and periodic on-site visits to consult with hospital administrators and staff on the most appropriate utilization of grant funds. The KRHFP is committed to working with partners who share the same activities and values. The KRHFP partners include but are not limited to, KY Hospital Association, KY Primary Care Association, KY Department of Public Health, KY Area Health Education Centers, KY Board of Emergency Medical Services, Murray State and Eastern and Western Universities. The goals of the KRHFP are: > Development and Implementation of Rural Health Networks > Support of existing CAHs and Eligible Hospitals > Improvement and Integration of EMS Services > Improving Quality of Care By allowing flexibility in providing services and in staffing levels and providing Medicare payment on a reasonable cost basis, the Critical Access Hospital designation has enabled many rural hospitals to continue to meet the needs of local residents. Through the KRHFP Conversion Program, a total of 32 rural hospitals have converted to critical access certification and formalized 32 referral networks. The KRHFP has continued to provide support to the states 30 existing CAHs through community health planning, facilitation, strategic planning and leadership development, as well as, identify mechanisms to increase their financial revenue streams through education, identification of their local market share, and the potential demand for additional health care services within their service area. A 2006 Program Evaluation of the KRHFP performed by Kentucky Rural Health Works found that overall, critical access certification appears to have improved the financial position of rural Kentucky hospitals. More importantly, the financial condition of Kentucky CAHs has not worsened since the implementation of the KRHFP in 2000. Kentucky is a state that has a significantly higher than average proportion of the population that is subject to chronic illness and death and has a higher than average percentage of the uninsured. Based on RUCC classifications (Rural Urban Continuum Codes), 35 of Kentucky's 120 counties are metropolitan and 85 are non-metropolitan; 44 percent of Kentuckian's live in rural counties compared to 17 percent for the United States. According to the 2002 Behavioral Risk Factor Surveillance System Kentucky has the highest percent of adults in the nation with barriers to healthcare. The KRHFP vision, goals and objectives coincide with those of Healthy People 2010: (1) To increase the quality and years of a healthy life; and (2) Eliminate our country's health disparities. 1
Effective start/end date9/1/008/31/09


  • Health Resources and Services Administration


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