Arizona Rural Hospital Flexibility Program

The Center for Rural Health coordinates the state’s Medicare Rural Hospital Flexibility Program (Flex Program).

​​​Since 1999, Arizona’s Rural Hospital Flexibility Program (AzFlex) has served as the premier technical assistance, training and information resource for populations served by Arizona’s federally designated Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs) and Community Health Centers (Federally Qualified and Tribal), trauma, Emergency Medical Services (EMS), and first responders. 

The AZ Flex goals focus on the following areas:

  • Improve the quality of rural health care.
  • Improve AZ-CAH financial and operational performance.
  • Support health system development and community engagement.
  • Enable CAH status to interested and eligible rural hospitals

Critical Access Hospitals (CAHs) have less than 25 inpatient beds, are 35 miles or more from another facility, staff a 24-hour/7days per week Emergency Department, and maintain acute care status by averaging less than 96 hours for an inpatient stay. Medicare reimburses CAHs on a reasonable cost basis for inpatient and outpatient services. Enhanced reimbursement through Medicare and state funding (such as the Arizona CAH Pool), help sustain crucial safety net services in rural communities.

Download AzFLEX Fast Facts

Arizona Rural Hospital Flexibility Program (AzFlex) – In 1999, the Center for Rural Health initiated the AzFlex Program, with funding from HRSA’s Medicare Rural Hospital Flexibility Program. Today, 17 rural Arizona hospitals have federal Critical Access Hospital (CAH) designation.

CAHs have less than 25 inpatient beds, are 35 miles or more from another facility, staff a 24-hour/7days per week Emergency Department, and maintain acute care status by averaging less than 96 hours for an inpatient stay. Medicare reimburses CAHs on a reasonable cost basis for inpatient and outpatient services. Enhanced reimbursement through Medicare and state funding (such as the Arizona CAH Pool), help sustain crucial safety net services in rural communities.

AzFlex offers support and technical assistance to CAHs in core areas including:

  • Performance and Quality Improvement
  • Operational and Financial Improvement
  • Population Health Management and Emergency Medical Services Integration
  • CAH Designation and De-designation

Critical Access Hospital (CAH)

A Critical Access Hospital is a rural acute care hospital consisting of no more than 25 inpatient beds. The Critical Access Hospital must not exceed a ninety-six (96) hour length of stay and will have agreements, contracts or affiliations for transfer and services. Critical Access Hospitals must also be located more than a 35-mile drive from any other hospital or CAH (in mountainous terrain or in areas with only secondary roads available, the mileage criterion is 15 miles).

Becoming a CAH

For additional information on what a CAH is and on how to be designated as one, please go to: Becoming a CAH Manual

Arizona Critical Access Hospitals

Learn more about our 17 existing CAHs (i.e., contact information, designation date, hospital profile and affiliated emergency services) and visit their websites:

A Rural Health Clinic (RHC) is a primary healthcare clinic located in a non-urbanized area that has been shown to have a shortage of healthcare services or healthcare providers, and has been certified as a Rural Health Clinic under Medicare. The greatest benefit of the program is cost-based (enhanced) reimbursement from Medicare and Medicaid. In 1977, Congress passed the Rural Health Clinic Act, or Public Law 95-210, to address the lack of access to primary medical care in rural communities and to assist with the financial challenges faced by rural healthcare facilities. In addition, this law focused on increasing the utilization of mid-level practitioners in underserved areas.

Becoming an RHC

A revised Arizona Rural Health Clinic Designation Manual will be available soon.

Compliance and Regulatory Priorities for Rural Health Clinics Recording by Kate Hill, watch here. 

Critical Access Hospital (CAH) Affiliated Rural Health Clinics in Arizona:

  • Banner Health Clinic-Page | 601 N. Navajo Drive | Page AZ |Navajo County | Banner Page Hospital
  • Banner Payson | 117 East Main Street, Suite A100 | Payson, AZ| Gila County | Banner Health Payson
  • Banner Pine | 6152 Hardscrabble Road | Pine, AZ | Gila County  | Banner Health Payson
  • Benson Hospital Family Healthcare | 688 W. 4th Street Suite B | Benson, AZ | Cochise County | Benson Hospital 
  • Benson Healthcare San Pedro | 890 W. 4th St. | Benson, AZ | Cochise County | Benson Hospital
  • Bouse Medical Clinic | 44031 E. Plomose Road, Box 866 | Bouse, AZ | La Paz County | La Paz Regional Hospital 
  • Cobre Valley Family Practice | 5994 S. Hospital Drive | Globe, AZ | Gila County | Cobre Valley Regional Medical Center 
  • Cobre Valley Kearny Clinic | 100 S. Hospital Drive | Globe, AZ | Pinal County | Cobre Valley Regional Medical Center
  • Cobre Valley Pleasant Valley Community Medical Center | 124 N. Tewksbury Boulevard | Young, AZ | Gila County | Cobre Valley Regional Medical Center
  • Cobre Valley Red Rock Clinic | 5990 S. Hospital Dr. | Globe, AZ | Gila County | Cobre Valley Regional Medical Center
  • Cobre Valley Superior Clinic | 1134 W. US Highway 60 | Superior, AZ | Pinal County | Cobre Valley Regional Medical Center
  • Cobre Valley Surgical Services  | 5880 S. Hospital Drive |Globe, AZ | Gila County | Cobre Valley Regional Medical Center
  • Cobre Valley Tonto Basin Clinic | 186 E. Stephens Way | Tonto Basin, AZ | Gila County | Cobre Valley Regional Medical Center
  • Community Hospital Association, Inc | 523 Rose Lane | Wickenburg, AZ | Maricopa County | Wickenburg Community Hospital 
  • Community Hospital Association, Inc | 26750 B South Santa Fe Road | Congress, AZ | Yavapai County | Wickenburg Community Hospital 
  • Community Hospital Association, Inc | 32919 N. Center Street, Suite B | Wittmann, AZ | Apache County | Wickenburg Community Hospital 
  • Copper Mountain Clinic | 2175 W 16th St Suite D | Safford, AZ | Mt. Graham Regional Medical Center
  • Copper Queen Community Hospital-Bisbee RHC | 7 Bisbee Road | Bisbee, AZ | Cochise County | Copper Queen Community Hospital 
  • Copper Queen Community Hospital-Douglas RHC | 100 E. 5th Street | Douglas, AZ | Cochise County | Copper Queen Community Hospital 
  • Copper Queen Community Hospital Hereford Clinic, 4524 East Hereford Rd Suite 1 |Hereford, AZ| Cochise County | Copper Queen Community Hospital
  • Copper Queen Community Hospital-Palominas Rural RHC  | 10524 E. Highway 92 | Palominas, AZ | Cochise County | Copper Queen Community Hospital 
  • Copper Queen Community Hospital-Tombstone Rural RHC  | 7 North San Diego St. | Tombstone, AZ | Cochise County | Copper Queen Community Hospital
  • Greasewood Clinic | PO Box 457, Highway 264 | Ganado, AZ | Apache County | Sage Memorial Hospital
  • La Paz Medical Services | 150 E. Tyson Road | Quartzsite, AZ | La Paz County | La Paz Regional Hospital 
  • Little Colorado Physicians Office | 200 E. Lee Street | Winslow, AZ | Navajo County | Little Colorado Medical Center 
  • River Health Clinic | 1200 W. Mohave Rd. | Parker, AZ | La Paz County | La Paz Regional Hospital 
  • Sage Outpatient Clinic | PO Box 457, Highway 264 | Ganado, AZ | Apache County | Sage Memorial Hospital 
  • Sulphur Springs Medical Center | 900 W. Scott | Willcox, AZ | Cochise County | Northern Cochise Community Hospital 
  • Sunsites Medical Clinic | 233 N. Frontage Road | Pearce, AZ | Cochise County | Northern Cochise Community Hospital 
  • Tri-Valley Medical Center | 39726 Harquahala Road | Salome, AZ | La Paz County | La Paz Regional Medical Center 
  • White Mountain Communities Hospital, INC. | 114 S. Mountain Avenue | Springerville, AZ | Apache County | White Mountain Regional Medical Center 

Other Arizona Rural Health Clinics

  • Family Behavioral Integrated Health Services-San Luis | 1453 N. Main Street, Suite 6 | Safford, AZ | Yuma County | Regional Center for Border Health
  • Family Medical Center PLLC | 1492 S. 20th Ave | Safford, AZ | Graham County | Family Medical Center
  • Gila Valley Clinic PC | 1680 S. 20th Avenue | Safford, AZ | Graham County 
  • Lake Havasu Pediatric and Family Clinic | 1940 Mesquite Ave | Lake Havasu, AZ | Mohave County | Regional Center for Border Health
  • Parker Medical Center, LTD | 905 South Fiesta Ave. | Parker, AZ | La Paz County
  • Parker Walk-In Clinic | 601 Riverside Drive Suite 2 | Parker, AZ | La Paz County | Regional Center for Border Health
  • Ponderosa Family Care | 127 Main St. Ste D | Payson, AZ | Gila County
  • San Luis Medical Mall | 151 S. Oak Ave Suite 2 | San Luis, AZ | Yuma County | Regional Center for Border Health
  • San Luis Urgent Care | 1233 N. Main Street, Suite 1A | San Luis, AZ | Yuma County 
  • San Luis Walk-in Clinic, Inc. | 950 E. Main Street, Building B | Somerton, AZ |  Yuma County
  • San Luis Walk-In Clinic, Inc. - Family & Adult Center | 1896 E. Babbit Lane | San Luis, AZ | Yuma County
  • San Luis Walk-In Clinic, Inc. - Urgent Care & Family Center | 214 W. Main Street | Somerton, AZ | Yuma County
  • Summit HC Family Med at Bison Ranch | 2352 Quarter Horse Trail | Overgaard, AZ | Navajo County  |  Summit Healthcare Medical Associates
  • Summit HC Family Med Eagar | 606 N Main Street | Eagar, AZ | Apache County  |  Summit Healthcare Medical Associates
  • Summit HC Family Med Snowflake | 1121 S Main Street | Snowflake, AZ | Navajo County  |  Summit Healthcare Medical Associates
  • Summit HC Family Med St Johns | 625 N 13th West | Saint Johns, AZ | Apache County  |  Summit Healthcare Medical Associates
  • Summit HC Pediatrics | 4951 S White Mountain Rd Building A | Show Low, AZ | Navajo County  |  Summit Healthcare Medical Associates
  • Summit HC Snowflake Medical Center | 590 S Main Street | Snowflake, AZ | Navajo County  |  Summit Healthcare Medical Associates
  • Verde Community Healthcare LLC | 657 E Cottonwood Street Suite 10 | Cottonwood, AZ | Yavapai County  |  Verde Community Healthcare

Access resources to Quality Network materials

Learn more about our operational/financial improvement initiatives and events.

Education Opportunities:

  • 2025 CAH & RHC Coding & Billing Bootcamp on April 15 & 16 from 9 am-3:30 pm  (in-person and virtual). Learn more HERE. Register HERE. 

Learn more about AZ Flex Program's support to EMS and rural hospital Emergency Departments.

  • Level IV Trauma Center Designation
  • Partnership with ADHS, Bureau of EMS and Trauma Systems

Quality Improvement Toolkit for EMS

Repository of Flex related resources.

AzFLEX CONTACTS

Jill Bullock, AzCRH Associate Director
bullock1@arizona.edu

Joyce Hospodar, Senior Advisor, Rural Programs
hospodar@arizona.edu

Brianna Rooney, Research Program Evaluator​
bcrooney@arizona.edu

Estefania Mendivil, Health Education & Promotion Professional II
emendivil@arizona.edu

Daniel Derksen, MD, Director, Principal Investigator
dderksen@arizona.edu