Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement | HRSA 22 062

Opportunity Information: Apply for HRSA 22 062

The Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement (HRSA 22-062) is a discretionary funding opportunity from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), aimed at strengthening health care delivery in rural communities. The program is designed to improve both the quality of care and the financial viability of rural health care providers by offering targeted technical assistance to organizations and facilities connected to the Federal Office of Rural Health Policy (FORHP) initiatives. In practical terms, the cooperative agreement functions as a support hub that helps rural hospitals and rural health stakeholders implement proven strategies, solve operational challenges, and build long-term capacity to remain stable and effective in serving rural populations.

A central focus of the opportunity is direct support for Medicare Rural Hospital Flexibility (Flex) Program beneficiaries. The Flex Program is closely tied to Critical Access Hospitals (CAHs) and rural systems of care, and this cooperative agreement is structured to help Flex recipients successfully carry out their program activities. Beyond Flex, the award also supports Small Rural Hospital Improvement Program (SHIP) recipients and extends assistance to CAHs, small rural hospitals, and rural communities more broadly. The overall intent is to provide hands-on, practical support that rural providers can use to improve performance, respond to evolving payment and quality requirements, and strengthen service delivery in settings that often face workforce shortages, tighter margins, and limited access to specialized expertise.

The stated objectives of the program fall into three main buckets. First, it provides assistance, capacity building, and ongoing support to Flex Program recipients. Second, it provides the same types of support to SHIP recipients. Third, it expands capacity building and technical assistance to Critical Access Hospitals, small rural hospitals, and rural communities. This includes helping recipients not just with one-time guidance, but with building systems and skills that can be maintained over time, such as better internal analytics, stronger management practices, and improved readiness for new models of care.

The technical assistance topics are broad but clearly oriented around real operational needs in rural hospital settings. Key assistance areas include financial and operational performance improvement (such as helping hospitals understand and strengthen margins, revenue cycle processes, staffing models, service line decisions, and cost controls) and benchmarking (helping organizations compare performance to peers and use data to set improvement targets). The opportunity also emphasizes community engagement and population health initiatives, reflecting a recognition that rural hospitals often act as anchor institutions and must coordinate with local partners to address community-wide health needs. Another area is strengthening rural emergency medical services (EMS), acknowledging the critical role of EMS in rural access to timely care, especially given longer transport times and limited facility options. The program also prioritizes quality improvement support, meaning assistance that helps rural providers implement and sustain quality and safety initiatives, measure outcomes, and meet reporting expectations. Finally, it includes building capacity to participate in alternative payment models, which can involve preparing hospitals and communities to succeed under value-based purchasing, accountable care approaches, and other reimbursement structures that reward quality and efficiency rather than volume alone.

From an administrative and funding standpoint, this opportunity is offered as a cooperative agreement, which generally means HRSA expects substantial involvement and collaboration with the awardee during the project period rather than a more hands-off grant relationship. The funding opportunity lists an award ceiling of $1,100,000 and anticipates making one award, indicating HRSA likely intends to fund a single national or multi-regional technical assistance provider (or lead organization) that can serve many rural stakeholders. The CFDA number associated with the program is 93.155. The opportunity was created on December 28, 2021, with an original application closing date of February 28, 2022.

Eligibility includes federally recognized Native American tribal governments, other Native American tribal organizations, and additional eligible entities as described in the opportunity’s eligibility clarification text. Overall, the cooperative agreement is best understood as funding for an organization capable of delivering structured, high-impact technical assistance to rural hospitals and rural health systems, with the end goal of improving rural health care quality, strengthening operational and financial stability, and helping rural providers adapt to a changing health care environment.

• The Department of Health and Human Services, Health Resources and Services Administration in the health sector is offering a public funding opportunity titled "Information Services to Rural Hospital Flexibility Recipients Cooperative Agreement" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.155.
• This funding opportunity was created on Dec 28, 2021.
• Applicants must submit their applications by Feb 28, 2022. (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 $1,100,000.00 in funding.
• The number of recipients for this funding is limited to 1 candidate(s).
• Eligible applicants include: Native American tribal governments (Federally recognized), Native American tribal organizations (other than Federally recognized tribal governments), Others (see text field entitled Additional Information on Eligibility for clarification).

Apply for HRSA 22 062

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