UNIVERSITY PARK, Pa. — The Pennsylvania Medicare Rural Hospital Flexibility (Flex) Program received a 2026 Medicare Beneficiary Quality Improvement Project (MBQIP) Certificate of Excellence Award in recognition of outstanding critical access hospital (CAH) state quality reporting and performance. The Pennsylvania program was ranked in the top five nationally.
In 2019, 2024 and 2025, the program was ranked No. 1. Pennsylvania is one of only two states to have been ranked as No. 1 for two years in a row and one of very few programs to be in the top five for three consecutive years.
The award was presented on July 16 at the annual Medicare Rural Hospital Flexibility Program Reverse Site Visit in Washington, D.C., and was given by the Federal Office of Rural Health Policy (FORHP) in the U.S. Department of Health and Human Services’ (DHHS) Health Resources and Services Administration (HRSA). Lannette Fetzer, quality improvement coordinator; Sandee Kyler, rural health systems manager and deputy director; and Lisa Davis, director and outreach associate professor health policy and administration at the Pennsylvania Office of Rural Health (PORH), accepted the award on behalf of the state’s 18 CAHs.
PORH provides expertise in the areas of rural health, agricultural health and safety, and community and economic development. PORH is administratively housed in the Department of Health Policy and Administration in the College of Health and Human Development at Penn State University Park.
MBQIP is a quality improvement activity under the Medicare Rural Hospital Flexibility (Flex) grant program of FORHP. The goal of MBQIP is to improve the quality of care provided in CAHs by increasing quality data reporting by CAHs and then driving quality improvement activities based on the data. MBQIP is a voluntary reporting system that includes quality and satisfaction measures from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare plus a CAH-specific Emergency Department Transfer Communication measure set. Pennsylvania was one of the first four states to have 100% CAH participation in MBQIP.
“Pennsylvania is fortunate to have 18 Critical Access Hospitals dedicated to delivering exceptional care in rural communities. The quality improvement directors at each of these hospitals are deeply committed to ensuring the highest standards of care for the patients and communities they serve,” said Fetzer. “Their dedication to quality, safety, and continuous improvement is reflected in the compassionate, patient-centered services provided every day. It is truly a privilege to partner with these hospitals as they continue to advance excellence and set a strong example for rural health care across the commonwealth.”
“Achieving national recognition for three consecutive years reflects the extraordinary commitment of Pennsylvania’s critical access hospitals to continuous quality improvement and exceptional patient care,” Kyler said. “This award is a testament to the dedication of hospital leaders, clinicians and staff who work every day to ensure rural communities have access to safe, high-quality health care. It honors the people who care for their neighbors, friends and families every day and whose commitment strengthens the health and vitality of rural communities across Pennsylvania.”
The Medicare Rural Hospital Flexibility Program was established through the Balanced Budget Act of 1997, the Balanced Budget Refinement Act, the Benefits Improvement and Protection Act, and the Medicare Modernization Act. This program improves access to preventive and emergency health care services for rural populations. Providing federal grant funding to eligible states, the program requires states to address rural health network development and directs significant effort into designating CAHs, which are small hospitals (25 beds or fewer) in rural counties that serve high Medicare, Medicaid, low income, and uninsured populations. Pennsylvania has 18 CAHs.
PORH was formed in 1991 as a joint partnership between the federal government, the Commonwealth of Pennsylvania and Penn State. The office is one of 50 state offices of rural health in the nation funded under a program administered by FORHP and is charged with being a source of coordination, technical assistance and networking; partnership development; and assisting in the recruitment and retention of health care providers.