The One Big Beautiful Bill Act, signed into law earlier this summer, created the Rural Health Transformation (RHT) Program, an initiative launched by the Centers for Medicare & Medicaid Services (CMS) to help rural communities redesign their healthcare delivery systems, expand access to quality care, develop the workforce, and improve health outcomes through innovation and support long-term financial sustainability. All 50 states are eligible to apply for RHT funding; however, Washington, D.C. and U.S. territories are ineligible.

Funding Opportunity:

• $50 Billion Over Five Fiscal Years (FY 26–30) – $10B Per FY
  • Baseline Funding – 50% of funds ($25B total/$5B per year) will be distributed equally across all participating states. If all 50 states apply (which CMS expects), each state will receive at least $100 million annually over five years.
  • Workload Funding – 50% of funds ($25B/$5B per year) will be distributed based on two scores: (1) Rural Facility and Population score and (2) Technical score. The Rural Facility and Population score is calculated based on data-driven metrics compared to other states, while the Technical score is calculated based on data-driven metrics, qualitative assessment of each state’s initiatives within their applications and current state policy actions.

Allowable Use of Funding:

States will use awarded funds to invest in at least three of these permissible uses and create a transformation plan. Please refer to the NOFO for more information.

• Prevention and chronic disease
• Appropriate care availability
• Provider payments
• Behavioral health
• Consumer tech solutions
• Innovative care
• Training and technical assistance
• Capital expenditures and infrastructure
• Workforce
• Fostering collaboration
• IT advances

How Rural Providers Can Transform Through the RHT Program, and What to Do Right Now

What Rural Health Providers Should Do Now

Federally Qualified Health Centers (FQHCs) and rural providers play a key role in shaping their state’s RHT strategy. Join stakeholder meetings, advisory boards, and working groups to ensure your priorities are represented. Stay engaged and alert for opportunities to influence your state’s application and implementation process.

Key Considerations for Rural Health Providers

1. Leading Rural Care and Building Strategic Partnerships:
   FQHCs and rural provider groups will lead the redesign of rural care delivery, focusing on primary, preventive, and behavioral health services. Through strategic partnerships, they will enhance care coordination with the goal of improving quality outcomes and reducing the total cost of care.
2. Access to Resources for Transformation:
   Depending on each state’s program design, FQHCs and provider groups may receive access to technical assistance and transformation planning tools. These supports can enable workforce development; population health management – for instance analytics and care management workflow tools; care integration and infrastructure improvement; all tailored to the needs of rural communities.
3. Flexibility to Lead in Innovation:
   FQHCs can leverage the RHT Program to pilot innovative care models, shape value-based payment approaches and explore alternative payment methodologies. This may include consideration for creating or joining a Medicare Shared Savings or REACH ACO to engage in value-based care for fee-for-service Medicare beneficiaries, as well as an IPA for value-based care agreements with health plans for Medicare Advantage (MA), Dual Eligible Special Needs Plans (D-SNP), Medicaid managed care and commercial including the ACA marketplace products.

How CHS Can Support:

COPE Health Solutions (CHS) supports a wide network of FQHC and rural health providers including FQHCs, RHCs, medical groups, clinically integrated networks (CINs) and rural hospitals through financial optimization, population health strategy, value-based care enablement and care model redesign solutions. As CMS rolls out the Rural RHT Program, we’re ready to help you take full advantage of this pivotal opportunity.

CMS’s preliminary guidance highlights key areas such as:

• Population health infrastructure redesign
• Rural health network development
• Workforce and talent recruitment
• Value-based care initiatives
• Expansion of remote care services

CHS brings deep expertise in all these project areas – and how to leverage them to improve your long-term financial sustainability while improving quality outcomes.

This funding opportunity directly aligns with the strategic and infrastructure gaps we have been helping FQHCs and rural providers solve for and close for decades.

Now is the time to act. CHS can help you develop a winning strategy to pursue this funding and build a sustainable, value-driven future for your organization and the communities you serve. Contact us at info@copehealthsolutions.com to learn how we can support your goals towards creating quality and accessible rural health care in your community.