Medicare Rural Hospital Flexibility Program Evaluation Cooperative Agreement | HRSA 18 037

Opportunity Information: Apply for HRSA 18 037

The Medicare Rural Hospital Flexibility Program Evaluation Cooperative Agreement (HRSA-18-037) is a federal funding opportunity from the U.S. Department of Health and Human Services, specifically the Health Resources and Services Administration (HRSA) within the Federal Office of Rural Health Policy (FORHP). It was offered in fiscal year 2018 as a discretionary cooperative agreement, meaning the awardee would work closely with the federal program office rather than operating entirely independently. The central goal is to strengthen Critical Access Hospitals (CAHs) by producing practical, usable data and analysis that can guide real improvement work in rural hospital settings.

At its core, the program is designed to function as an evaluation and analytic resource for the Medicare Rural Hospital Flexibility (Flex) Program. The funded entity is expected to collect, organize, and analyze relevant information in ways that help CAHs understand how they are performing and where they can improve. The emphasis is not only on measurement for its own sake, but on turning findings into actionable insights that hospitals and state Flex programs can apply to day-to-day decisions. By supplying evidence, benchmarks, and best-practice guidance grounded in data, the cooperative agreement aims to support better outcomes in rural health care delivery.

The opportunity highlights several specific improvement areas that the analysis work should inform. One major focus is financial and operational improvement, which can include helping CAHs understand cost drivers, revenue patterns, efficiency opportunities, and operational practices that support long-term sustainability in rural markets. Another major focus is quality of care reporting and quality improvement, aligning data and evaluation activities with the kinds of reporting and performance improvement efforts CAHs must undertake and benefit from. The program also calls out emergency medical services (EMS) integration, reflecting the reality that rural hospitals often rely heavily on well-coordinated pre-hospital and inter-facility transport systems and need stronger linkages across the continuum of emergency care. In addition, the grant underscores population health activities, pointing to broader efforts to use data to identify community health needs, target interventions, and coordinate with partners beyond the hospital walls.

A key feature of the program is that CAHs are expected to gain access to analyses of relevant data and evidence-based best practices. In practical terms, this means the work should go beyond one-off reports and instead generate products, tools, or findings that rural hospitals can use to compare performance, learn what strategies are working in similar facilities, and implement improvements with a clearer understanding of the likely impact. The results are also meant to be shareable and scalable: improvement efforts focused on CAHs should not only help the participating or directly supported hospitals, but also produce insights that can inform other CAHs and state Flex programs across the country, reinforcing the idea of spreading effective strategies through shared learning.

From an applicant standpoint, eligibility is broad and includes nonprofit organizations with IRS 501(c)(3) status (excluding institutions of higher education in that specific nonprofit category), private institutions of higher education, for-profit organizations other than small businesses, Native American tribal organizations (other than federally recognized tribal governments), and other entities as allowed under the additional eligibility guidance. The funding announcement lists a single expected award, with an award ceiling of $1,500,000, signaling that HRSA intended to fund one organization to serve as the primary national evaluation and analysis partner for this effort. The opportunity was posted on December 21, 2017, with an original application deadline of February 23, 2018, and it is associated with CFDA number 93.241.

Overall, this cooperative agreement is essentially an investment in the evaluation infrastructure behind rural hospital improvement. Instead of funding individual hospitals directly for services, it funds a centralized analytic and evaluation function so that CAHs can make better-informed decisions about finance, operations, quality, EMS integration, and population health, while also creating knowledge and best practices that can be disseminated across the broader rural hospital and state Flex program landscape.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Medicare Rural Hospital Flexibility Program Evaluation Cooperative Agreement" 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 Dec 21, 2017.
• Applicants must submit their applications by Feb 23, 2018. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $1,500,000.00 in funding.
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For profit organizations other than small businesses, Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for HRSA 18 037

[Watch] Creating a grant proposal using the step-by-step wizard inside the applicant portal: