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Arizona's Unique Challenges

Arizona, like other western states, faces unique challenges in assuring access to quality health care for its rural residents:  a permeable border with Mexico and a burgeoning problem of uncompensated care for the hospitals that serve this population; a large number of American Indian Nations, whose tribal members live in some of the most remote and isolated areas of the state; geographical terrain that ranges from the floor of the Grand Canyon to the snow-covered White Mountains in the north; from farmlands to barren desert in the south; rural patient populations ranging from farmworkers to tourists, from Navajo elders to young mothers in need of obstetric care.  Arizona has relatively few small rural hospitals serving such a diverse population in such diverse regions of the state.   

As part of the Balanced Budget Act of 1997, Congress created the Medicare Rural Hospital Flexibility Program to protect and stabilize the nation's fragile rural health care infrastructure by creating a new category of rural hospitals -- critical access hospitals -- and offering them revenue enhancements through cost-based reimbursement for services to Medicare patients.  The Rural Health Office administers Arizona's Rural Hospital Flexibility Program, guided by key state stakeholders through the statewide Flex Leadership Advisory Group (FLAG).  Eleven of Arizona's eligible rural hospitals, including Indian Health Service and tribally-owned hospitals, are designated critical access hospitals. 

As rural communities continue to face the challenge of improving the delivery of health care for their residents, the Medicare Rural Hospital Flexibility Program seeks to address this issue by encouraging development of collaborative rural health networks that include critical access hospitals, tertiary hospitals, emergency medical services providers, and other local health care and social services providers. The goal of this "networked community health" strategy is to improve access to primary and preventive services, enhance the quality of services provided, and create financial and administrative stability for local community hospitals in rural areas of the state.