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Tags Posts tagged with "Rural Health Transformation Plan"

Rural Health Transformation Plan

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RCPA has been a long-time partner of the Center for Health Care Strategies (CHCS), a policy design and implementation organization devoted to improving outcomes for people enrolled in Medicaid. Our collaborative efforts across the arena of Medicaid and the pending impacts of HR 1 remain a critical connection point to ensure access in Pennsylvania.

On behalf of CHCS, RCPA would like to share this update on resources related to the Rural Health Transformation Project. Per the update:

The federal Rural Health Transformation Program (RHTP), authorized under the 2025 budget reconciliation act (P.L. 119-21), will distribute $50 billion to all 50 states from 2026 to 2030 — serving as a partial offset to Medicaid cuts. In designing and launching RHTP plans, state agencies must meet ambitious federal expectations and timelines. Experiences from other large-scale statewide efforts — such as the American Rescue Plan Act, Opioid Settlement Funds, multisector plans for aging (MPA), and the Centers for Medicare & Medicaid Services’ (CMS) State Innovation Models (SIM) demonstration — can help inform state planning.

This brief provides practical recommendations to help states establish the administrative infrastructure needed to implement their RHTP plans. Drawing on insights from state officials involved with similar transformation efforts, as well as the Center for Health Care Strategies’ (CHCS) experience supporting this work, the brief highlights best practices and common pitfalls across four core domains:

  1. Governance;
  2. Stakeholder engagement and communications;
  3. Budget tracking, reporting, and contracting; and
  4. Data and evaluation.

While not exhaustive, this brief outlines practical lessons that state staff can use to guide RHTP activities during the critical first six to nine months of program design and implementation, helping states build a strong foundation for long-term success.

Additionally, CHCS published a series of tip sheets to aid stakeholders in exploring strategies and initiatives within the project. The tip sheets offer resources for strengthening rural health, including workforce and access issues.

If members have any questions regarding this update or the Rural Health Transformation Plan, please contact RCPA COO Jim Sharp.

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Following the creation of the Rural Health Transformation (RHT) Program under President Trump’s Working Families Tax Cut legislation, the Centers for Medicare and Medicaid Services (CMS) has announced the establishment of the Office of Rural Health Transformation (ORHT). This new office will be located within the Center for Medicaid and CHIP Services (CMCS) and will continue overseeing the RHT Program. The RHT Program is a $50 billion initiative to strengthen rural health systems and expand access to care nationwide. As noted in RCPA’s Alert from December 30, 2025, Pennsylvania will receive nearly $200 million in 2026.

ORHT, which announced approved awardees on December 29, 2025, will guide states in implementing their rural health transformation plans, provide technical assistance, coordinate federal and state partnerships, and ensure strong oversight and accountability throughout the five-year program, which will run through September 30, 2031.

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From Pennsylvania Capital-Star “Pa.’s Rural Health Application Reveals Priorities in Federal Funding Request,” November 20, 2025:

Pennsylvania is hoping to secure its own slice of a $50 billion rural health fund in the face of federal Medicaid cuts, with a focus on bolstering a beleaguered workforce and expanding health access for more than two million people.

The Rural Health Transformation Fund was a last-minute addition to President Donald Trump’s summer budget bill that imposed Medicaid work requirements and cut upwards of $51 billion in funding to the commonwealth over the next decade. That new fund is worth roughly 37% of the estimated lost Medicaid funding in rural areas…

The 67-page application requests up to $200 million in annual funding over the next five years, totaling $1 billion. Its six focuses include: technology and infrastructure, workforce, maternal health services, behavioral health services, aging and access, and emergency medical services and transportation.

The U.S. Department of Human Services is expected to award funding by the end of the year.

Key objective targets are:

  • Access to care: More than 85% of Pennsylvanians can get a routine primary care appointment within four weeks and urgent care appointments within one week.
  • Digital connectivity and telehealth: More than 85% of rural hospitals and clinics will have broadband and telehealth functionality. More than 50% of rural hospitals and clinics connected via Fast Healthcare Interoperability Resources.
  • Workforce adequacy: Reduce rural hospital vacancy rates by 10% for key direct care roles. Add three new rural training programs.
  • System sustainability: More than 60% of systems partnered with rural Community Health Centers for specialty care.
  • Health outcomes: Reduce the number of pregnant women living in rural areas with inadequate prenatal care by 20%.

From the PA Rural Health Transformation (RHT) Program Application:

Pennsylvania’s rural health transformation strategy is grounded in a balance of statewide coordination and regional leadership and collaboration. Pennsylvania’s “Health Hub” state agencies (Human Services, Health, Aging, Insurance, Drug and Alcohol Programs), and other partner agencies will establish clear strategic priorities focusing on access, workforce, maternal health, aging, behavioral health, EMS and infrastructure. Pennsylvania will leverage statewide technical expertise, evaluation, and financial oversight and support. Strong regional rural care collaborative will be composed of a roster of regional stakeholders that prioritize local needs, develop effective local sustainable solutions, and leverage existing resources and assets.

Pennsylvania will leverage established regional entities that coordinate regional economic development. These Partnerships for Regional Economic Performance (PREP) organizations are long-standing, quasi-governmental organizations that convene regional stakeholders, administer federal and state grants, collect local data, report outcomes, and catalyze public and private partnerships for regional economic development. They bring established governance structures, convening power, and a track record of successful cross-sector collaboration. PREPs (Figure 2) will convene regional stakeholders to create Rural Care Collaborative (RCCs) to align initiatives with regional economic planning and development – making the RHTP investments sustainable and promoting long-term partnerships.

If you have any questions, please contact RCPA COO and Mental Health Policy Director Jim Sharp.

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Thank you for your participation in Pennsylvania’s rural health ecosystem, including those who attended a regional rural health summit. As a next step, DHS is gathering information, concepts, and additional ideas to shape the Commonwealth’s Rural Health Transformation Plan and reflect what they heard from rural providers, partners, and residents.

What DHS is asking for:

  1. Information and concepts in these summit-affirmed areas: Maternal Health, Mental and Behavioral Health, Aging and Access, Transportation and EMS, and the Rural Healthcare Workforce.
  2. Other ideas that improve access to care in rural communities, even if they fall outside those five areas.

Who can submit:

  • Hospitals and health systems;
  • Healthcare professionals;
  • FQHCs and rural health clinics;
  • State offices of rural health;
  • Grantees providing services in rural areas;
  • Healthcare leadership and administrators;
  • Healthcare consumers;
  • Community action organizations;
  • Public and private business owners and organizations;
  • EMS and transportation providers;
  • Behavioral health, aging, and disability services partners, county commissioners, and other local or state government representatives, single county authorities, economic development organizations, professional organizations, community-based and faith-based organizations, philanthropy, and higher education and health provider training partners; and
  • Other interested parties.

What to include:

Information to assist DHS in enhancing and transforming rural health, including core concepts, target problems, or opportunities for improvement, intended impact and success metrics, evidence or prior experiences, feasibility of ideas for rural settings, partners, costs and resources, innovation or adaptation, and sustainability.

Submit by: August 29, 2025
Find the Form Here
Questions or Accessibility Needs: Email

DHS may use the information gathered through this process in the development of future implementation; however, the Departments do not guarantee that this will occur.

Respondents should be aware that the responses will be public information and that no claims of confidentiality will be honored. DHS is not requesting, and does not require, confidential, proprietary information, or other competitively sensitive information to be included as part of a submission. Ownership of all data, material and documentation originated, prepared, and provided to the Departments during this process will belong exclusively to the Departments.

Please contact your RCPA Policy Director with any questions.

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