The North Carolina Rural Health Research and Policy Analysis Center and the UNC Department of Health Policy and Administration are collaborating with the other rural health research and policy analysis centers in a comprehensive review of the Rural Hospital Flexibility Program (Flex Program). Along with the other collaborators, UNC will use a combination of primary and secondary data collection to evaluate the program effects. UNC will conduct:

• A quarterly e-mail survey of state Flex/CAH program coordinators and staff in the CMS central office to monitor changes in CAH conversions and emerging issues. Information gather during these e-mail exchanges will be compiled to form the CAH Management information dataset.
• An extensive telephone interview of Flex Coordinators and key stakeholders in selected states will be used to assess how the Flex Program has contributed to states rural health policy development, planning and capacity development priorities and initiatives. The project will also identify the states perceptions of their needs for the future.
• Case studies to examine the effects of CAH hospital closures on access to care for residents and on the local economy. In order to get a better understanding of the impact of hospital closings over time, UNC will select an additional four communities where small rural hospitals, with a profile that closely resembles that of CAH hospitals, closed in the mid to late 1990s.

There may be products related to this project; please contact the lead researcher for more information.