As part of its mission to support the delivery of high-quality healthcare across Montana, MHREF has helped test and advance alternative models that rethink the delivery and design of healthcare, especially for rural and frontier communities.

MHREF may be best known as the agency that administered the Medical Assistance Facility (MAF) Demonstration Project for eleven years.

The MAF was the nation’s first—and is recognized as its most successful—limited service rural hospital model. The project was created to ensure access to health care services in frontier areas that otherwise could not maintain acute care services. The Critical Access Hospital (CAH) program, authorized by the Balanced Budget Act of 1997,  is based on Montana’s MAFs. MHREF administers major portions of the federal Rural Hospital Flexibility Grant to support CAH facilities at the request of the Department of Public Health and Human Services (DPHHS).

MHREF also administers the Montana Capital Assistance Program, a joint venture with the Montana Facility Financing Authority, and assists hospitals with rural health clinic conversions.