The Center for Rural Health (CRH) at the University of Arizona Mel and Enid Zuckerman College of Public Health was awarded a three-year $1.5 million grant by the Health Resources and Services Administration (HRSA) to support the Arizona Medicare Rural Hospital Flexibility Program (AzFlex).

The program provides quality, operational and performance improvement in Arizona’s rural hospitals and affiliated outpatient services.

Arizona’s 14 critical access hospitals and 21 rural health clinics play crucial roles in assuring access to quality health care, improving population health outcomes and contributing to a community’s overall economic health and development.

The AzFlex program provides technical assistance, training and information resources for Arizona’s Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs) and a statewide network of rural primary care, trauma and emergency medical services (EMS) providers.

The AzFlex work plan for the next three years has four program areas: quality improvement, financial and operational improvement, population health management and EMS integration and Critical Access Hospital designation in Arizona.

“The Center for Rural Health is ideally suited to carry out this important work in Arizona’s rural communities,” said Daniel Derksen, MD, director of the CRH and principal investigator for the grant.

The CRH also also houses the Navigator Consortium, the Small Rural Hospital Improvement Program (AzSHIP) and the State Office of Rural Health (AzSORH).

“While our Critical Access Hospitals’ fiscal performance improved in 2014, we face new threats,” said Jill Bullock, CRH associate director and AzFlex program manager.

Some of the threats Bullock cites include the five percent Medicaid hospital payment cut, lower participation rates in Medicaid and Marketplace coverage in rural, Hispanic and American Indian populations served by Arizona’s CAHs and RHCs, new state and federal regulations and requirements to report on quality, satisfaction and other performance measures.

“Those threats are ominous. Over the last five years, 58 rural hospitals have closed, including one in Douglas where 70 people lost their jobs,” said Dr. Derksen who testified on the issues challenging rural hospitals and health services before the health subcommittee of the U.S. House Committee on Ways and Means in July 2015.