Rural Quality Improvement Technical Assistance: Support Strategies for Better Care

Rural healthcare providers often face financial limitations, staffing gaps, and technological constraints that can affect quality and access. These issues are intensified by public reporting requirements and limited administrative support. To help hospitals and clinics meet these challenges, the federal government funds Rural Quality Improvement Technical Assistance (RQITA).¹

RQITA offers tailored guidance and resources to rural providers, helping them improve patient care, comply with reporting standards, and build internal quality improvement (QI) processes that support long-term success.

This article looks at how RQITA supports rural hospitals through tailored guidance, MBQIP participation, and practical tools that strengthen internal quality efforts. You’ll also see how leaders can apply these resources strategically, and how it all connects to broader reporting and reimbursement models like Method 2 billing.

What Is Rural Quality Improvement Technical Assistance?

Rural Quality Improvement Technical Assistance (RQITA) is funded by the Federal Office of Rural Health Policy (FORHP) to support rural hospitals and clinics in quality reporting and improvement.¹

As a national initiative, RQITA focuses on delivering structured, scalable support to Critical Access Hospitals (CAHs) and other rural providers involved in quality reporting and improvement.

How RQITA Supports MBQIP Participation

The Medicare Beneficiary Quality Improvement Project (MBQIP) is a voluntary quality reporting initiative for CAHs funded through the Medicare Rural Hospital Flexibility (Flex) Program.³ RQITA provides direct support to help hospitals successfully participate in MBQIP by offering assistance across four quality domains:

• Patient safety

• Patient engagement

• Outpatient care

• Care transitions

For example, many CAHs struggle with reporting consistency due to staff turnover or time constraints. RQITA supports these facilities by offering simplified data collection tools, one-on-one coaching, and shared learning sessions. This helps teams understand what measures to report, how to collect data reliably, and how to use that data to inform decisions.

Real-World Example: RQITA in Action

Here’s how RQITA support might play out in a situation familiar to many rural hospitals:

A rural hospital participating in MBQIP was having difficulty with its Emergency Department Transfer Communication (EDTC) measure. Staff weren’t consistently documenting key information, and the quality team wasn’t sure how to improve without adding more burden to an already stretched workforce. With guidance from RQITA, the hospital identified where communication was breaking down and worked with staff to design a simple, sustainable process that fit their workflow.

The team:

• Met with frontline staff to understand common barriers during transfers

• Mapped out the typical transfer workflow to identify missed steps

• Clarified roles and responsibilities for each team member involved

• Created a checklist of essential data points to be documented during handoffs

• Integrated quick reminders into daily huddles to reinforce consistency

Over time, the new process became part of routine care. The hospital eventually built it into training for new staff, helping ensure the improvements would last. This example shows how leaders can use RQITA support to identify pain points, collaborate with frontline staff, and implement targeted changes that improve reporting and operational consistency.

Addressing Barriers Faced by Rural Providers

Many rural hospitals operate with limited resources. These constraints often make it difficult to maintain quality programs or interpret performance data.

RQITA responds with practical, targeted help in three key areas:

1. Scaled Support for Small Teams

Resources such as workflow templates and project guides are built with rural staffing models in mind. Facilities with limited QI staff can still conduct internal improvement projects using RQITA's simplified methods and checklists.

2. Building Internal Skill Sets

RQITA equips hospital teams with foundational QI training—often via webinars or virtual office hours. These sessions give nurses, administrators, and quality staff the tools they need to manage improvement work on their own, rather than depending on outside consultants.

3. Fostering Peer Connections

RQITA enables shared learning through regional or national collaboratives. These peer groups offer a chance for rural staff to compare strategies and results with others tackling similar issues. This is particularly valuable for isolated organizations where professional networking is limited.

How Healthcare Leaders Can Use RQITA Strategically

Healthcare executives, quality directors, and department leads can benefit from RQITA when planning improvement initiatives or reporting strategies. Leaders should consider RQITA a foundation for their internal quality infrastructure and align it with larger financial or compliance goals.

Recommended uses:

• Support staff training and onboarding: New quality staff can attend RQITA sessions or use downloadable guides to accelerate their understanding of MBQIP or other reporting systems.

• Improve reporting accuracy: For hospitals participating in programs like MBQIP or CMS value reporting, RQITA helps clarify data requirements and timelines.

• Align with reimbursement models: Quality performance influences payment eligibility, especially under Medicare models like Method 2 billing.

• Boost staff engagement: Participation in structured improvement work can improve retention and morale among rural teams who often wear many hats.

A Practical Investment in Rural Quality

Rural healthcare organizations need solutions that respect their capacity while still driving measurable improvement. Rural Quality Improvement Technical Assistance offers flexible, strategic resources that help hospitals meet benchmarks, improve workflows, and strengthen patient care efforts—regardless of their location or size.

For decision-makers aiming to make data-informed improvements and meet public reporting standards, RQITA offers a clear, practical path forward. And when paired with reporting tools like MBQIP or reimbursement strategies like Method 2 billing, it becomes a key pillar of sustainability for rural health organizations.

References

1. Health Resources and Services Administration. Rural Quality Improvement Technical Assistance Cooperative Agreement (HRSA-23-042). U.S. Department of Health and Human Services. https://www.hrsa.gov/grants/find-funding/HRSA-23-042

2. Health Resources and Services Administration. Medicare Beneficiary Quality Improvement Project (MBQIP). https://www.hrsa.gov/rural-health/grants/rural-hospitals/medicare-beneficiary-quality-improvement