Health Service Access in Rural Communities is sponsored by The Grant Portal. Supports projects that enhance healthcare access and infrastructure in rural communities, including maternal health services.

Rural Health Transformation | mydss. mo. gov Rural Health Transformation About the Program A New Era for Rural Health in Missouri: Understanding the Rural Health Transformation Program The Rural Health Transformation Program (RHTP) is a landmark $50 billion federal investment designed to reshape healthcare in rural communities across America.

1 Established by Public Law 119-21, this five-year program is not a short-term grant but a significant opportunity to build a stronger, more sustainable healthcare system for the future.

1 In Missouri, the Department of Social Services (DSS), through its MO HealthNet Division, is leading the state's application effort in close collaboration with the Department of Health and Senior Services (DHSS) and the Department of Mental Health (DMH). 3 What is the intention of the program?

For years, rural communities have faced unique healthcare challenges, including hospital closures, shortages of doctors and nurses, and overall poor health outcomes compared to urban areas. 1 The RHTP was created to address these long-standing issues head-on. The program represents a fundamental shift in federal policy.

Instead of providing temporary funds to patch financial holes, it aims to support states in making systemic, long-term changes. The goal is to move from a healthcare system that is struggling to survive in rural areas to one that is innovative, financially stable, and built for lasting success. 1 Strategic Goals The Five Strategic Goals The Centers for Medicare & Medicaid Services (CMS) has outlined five core goals that guide the RHTP.

These goals provide a clear roadmap for the types of projects Missouri will pursue to transform its rural healthcare landscape. The goal is about stopping people from getting sick before it happens, as well as ensuring appropriate access to early identification and upstream interventions.

It helps with projects that keep us healthy, looking at the main reasons for diseases like diabetes and heart problems, and make it easier to get important services like mental health and care for pregnant women. 1 The goal is to keep rural hospitals and clinics open by encouraging them to work together. This means they will share resources, improve how they operate, and become financially stable.

This way, they can continue to be trusted places for healthcare in their communities. 1 The goal is to help fix the shortage of healthcare workers in rural Missouri. It supports programs that bring in, train, and keep skilled workers, such as doctors, nurses, community health workers, and technicians.

1 The goal is to create a Community Health Hub, which brings hospitals, clinics, and other community leaders together to meet the health needs of their specific community. This will allow hospitals and clinics to get paid to help patients stay healthy in addition to helping treat them when they get sick. 1 The goal is to use new technology to make healthcare better in rural areas.

This means using things like video calls for doctor visits, keeping track of patients from far away, and safely sharing information. This will make healthcare easier and faster for people and doctors in rural areas. 1 Programmatic Activities RHTP Timeline Programmatic Activities RHTP Timeline Note: Dates could be slightly updated as program implementation details are finalized.

Date Event April 17, 2026 Digital Readiness Survey Ends April 22, 2026 RHTP Overview Webinar April 29, 2026 RHTP Hospital Webinar May 6, 2026 RHTP Non-Hospital Providers Webinar May 13, 2026 RHTP Community Organization Webinar May 2026 Release Hub boundary map May - June 2026 Launch ToRCH Care Roadshows May 2026 APM Survey Launch Procurement Activities RHTP Timeline Procurement Activities RHTP Timeline Note: Dates could be slightly updated as program implementation details are finalized.

Date Event April 27, 2026 Publish Horizon 1 application guidance May 7, 2026 Announce Ambient AI RFI May 7, 2026 Launch Invitation for Bids (IFB) for Horizon 1 projects​ May 19, 2026 Launch Horizon 1 project pre-proposal conference Mid May 2026 Launch Hub Anchor application Mid May 2026 Launch webinar for Hub Anchor Application Support May 2026 Announce Community Information Exchange (CIE) procurement approach May 2026 Announce EMS Grant Toolbox of Strategies A Toolbox for Change: How Missouri Can Use RHTP Funds The RHTP provides states with a broad and flexible "toolbox" of approved activities.

To be approved, Missouri's plan must include investments in at least three of the eleven categories below. 1 These categories directly align with the program's five strategic goals. Prevention and Chronic Disease: Funding programs that use evidence-based methods to prevent and manage chronic conditions.

Example: Expanding the use of providers such as Pharmacists, Community Paramedics and Community Health Workers to address chronic diseases at their root cause. Making payments to healthcare providers for services, particularly as part of new, innovative payment models. Example: A new payment model for providers to help prevent diseases at their root cause in addition to treating those conditions.

Promoting technology that patients can use themselves to manage their health. Example: Using the latest technology tools, including Artificial Intelligence, to help predict and manage chronic diseases. Training and Technical Assistance: Helping rural hospitals adopt advanced technologies like remote monitoring, robotics, or artificial intelligence.

Example: Provide training to healthcare workers and others on the latest technology such as Artificial Intelligence to make their more efficient. Recruiting and retaining healthcare professionals in rural areas, with a requirement that they serve in the community for at least five years. Example: Connecting rural high school students who are interested in health care careers with internships and other healthcare related opportunities.

Providing funds for significant upgrades to information technology, including software, hardware, and cybersecurity. Example: Connecting rural healthcare facilities with specialists using telemedicine for complex and urgent medical and behavioral health care. Appropriate Care Availability: Assisting rural communities in determining the right mix of healthcare services they need to be sustainable.

Example: Using a combination of technology such as telemedicine and additional workforce members such as community paramedics and pharmacists to connect patients with the right care at the right time at the right place. Supporting access to mental health and substance use disorder treatment. Example: Funding the two-year college education for front-line behavioral health workers.

Developing new models of care, including value-based payment arrangements. Example: Establishing local community-based health Hubs across the state in which hospitals, doctors, rural clinics, behavioral health providers and community-based organizations like food pantries and school-based clinics work together to improve the health of their community.

Creating strategic partnerships between rural facilities and other providers to improve quality, financial stability, and access to care. Example: Establishing regional networks run by a collaboration of hospitals, clinics, and behavioral health professionals to coordinate the care most needed in their region. How Much Funding is Available?

How RHTP Funding Works: The Two Streams of Support for Missouri The RHTP will distribute a total of $50 billion nationwide over five federal fiscal years (2026-2030), with $10 billion made available each year. 1 1. Baseline Funding (50% of Total) Half of the program's total funds ($25 billion over five years) are designated as Baseline Funding.

1 This money is divided equally among all states that have an approved application. This provides a stable, predictable funding stream that Missouri can count on each year to form the foundation of its transformation plan. If all 50 states are approved, this would amount to approximately $100 million per state annually.

10 2. Workload Funding (50% of Total) The other half of the program's funds ($25 billion over five years) is designated as Workload Funding. 1 This funding is distributed competitively based on a formula that evaluates two things: a state's level of rural need and the quality of its transformation plan.

1 This creates an opportunity for Missouri to earn significant additional funding by clearly demonstrating its rural health challenges and presenting a thoughtful, strategic, and high-impact plan for the future. How Much Did Missouri Receive? Missouri Department of Social Services (DSS) announced that the Centers for Medicare & Medicaid Services (CMS) has approved $216,276,817.

66 million in Year 1 (through September 30, 2027) funding for the state’s Rural Health Transformation Program (RHTP), marking a major step forward in strengthening and stabilizing rural health care across the state. The funding launches full implementation of Transformation of Rural Community Health (ToRCH) Care – Missouri’s statewide transformation strategy.

To view the Year 1 budget narrative and funding breakdown, visit the MO RHTP Year 1 Fund Distribution . Funding Timeline Funding Timeline Funding is awarded in five annual budget periods. A key feature of the program is its flexibility; for each budget period, Missouri will have until the end of the following federal fiscal year (September 30) to spend the awarded funds.

1 For example, funds awarded for the first budget period in early 2026 can be spent until September 30, 2027. This will require careful planning for complex, multi-year projects. For each budget period, recipients will have until the end of the following fiscal year (September 30) to spend awarded funding.

Recap: Budget Period will start on December 31, 2025. The Federal Fiscal Year begins October 1, but the subsequent Budget Period funding for RHTP will be distributed in November of each fiscal year. Key Limitations Prohibited Uses RHTP funds cannot be used for the following: New Construction: Building entirely new facilities is not allowed.

However, funds can be used for renovations, alterations, or equipment upgrades in existing buildings. 1 Supplanting Funds: The money is intended for new or expanded activities. It cannot be used to replace or substitute existing state, local, or private funding for a project that is already underway or budgeted.

1 Duplicating Billable Services: Funds cannot be used to pay for clinical services that are already reimbursable through programs like Medicaid, Medicare, or private insurance. The goal is to transform care delivery, not just pay for more of the same services. 1 Lobbying: Federal funds cannot be used for activities designed to influence the passage of legislation or other government actions.

1 Program-Specific Funding Caps CMS has also set limits on how much of a state's annual award can be spent on certain categories. These caps ensure a balanced investment across different aspects of healthcare transformation.

Administrative Costs (State-level program management, oversight) 10% of the state's total annual award 1 Capital Expenditures (Renovations, equipment upgrades) 20% of the state's total annual award 1 Provider Payments (For direct healthcare services not otherwise billable) 15% of the state's total annual award 1 Replacing an Existing Certified EHR System 5% of the state's total annual award 1 "Rural Tech Catalyst Fund" Initiatives (Funding for health tech startups) The lesser of 10% of the annual award or $20 million 1 Calculating Missouri's Award The Federal Scoring Formula The amount of competitive "Workload Funding" Missouri receives each year is determined by a formula that combines two distinct scores.

Understanding this formula is key to maximizing the state's award. Score 1: The Rural Facility and Population Score (The "Need" Score) This score is a snapshot of Missouri's existing rural healthcare needs and challenges. It is calculated by CMS only once at the beginning of the program and will not change over the five years 1 .

It is based on several data-driven factors, including: The total number of people living in rural areas of the state. 1 The number and proportion of rural health facilities, such as Critical Access Hospitals and Rural Health Clinics. 1 The level of uncompensated care provided by hospitals in the state.

1 The percentage of the state's total population that lives in rural areas. 1 The state's total land area and the presence of very remote "frontier" areas. 1 The percentage of hospitals that receive Medicaid Disproportionate Share Hospital (DSH) payments.

1 Score 2: The Technical Score (The "Plan and Performance" Score) This score measures the quality, strategic vision, and ultimately the performance of Missouri's transformation plan. This score is recalculated by CMS every year based on the state's progress. 1 This annual rescoring is the program's core accountability engine.

It turns the RHTP from a simple grant into a dynamic, performance-based partnership. A typical grant provides funding based on an initial application, with reporting focused mainly on compliance. The RHTP, however, ties future funding directly to present performance.

If Missouri successfully implements its planned initiatives and meets its policy commitments, its Technical Score—and its Workload Funding—can increase in subsequent years. Conversely, a failure to make progress or follow through on commitments can lead to a lower score and reduced funding.

This structure creates a powerful incentive for the state and its partners to not only write a strong plan but to execute it effectively, requiring robust project management and transparent reporting from day one. Vision & Core Objectives Vision Rural Missourians have access to the high-quality care they need, through or from a well-aligned delivery system that is built to last.

DSS is organizing and prioritizing initiatives in the application according to three overarching objectives: Ensure rural Missourians can access primary and behavioral health providers close to home, community-based maternity options, with connections to specialists and complex care enabled by telehealth and provider interoperability Strengthen healthcare quality through integrated care coordination, aligned incentives, and evidence-based practices – so rural Missourians consistently experience seamless, high-value care Strengthen the long-term sustainability of rural providers through targeted investments in infrastructure, adoption of innovative technologies, and payment models that reflect the realities of rural care delivery Initiatives Missouri’s Initiatives Rural Health Network and Hubs Tech and Data Interoperability Rural Health Workforce Pathways Provider Transformation & Sustainability Rural Health Network and Hubs Rural Health Network and Hubs Create community hubs supported by regional networks as the backbone that connects every rural resident to seamless high-quality care through: Access expansion through and beyond traditional providers (e.g., pharmacy, Emergency Medical Services (EMS), Mobile Integrated Healthcare–Community Paramedicine (MIH-CP), Local Public Health Agencies (LPHA)) Care coordination integrating physical, behavioral and social health services Technical assistance and programs tailored to local needs Rural Health Workforce Pathways Rural Health Workforce Pathways Create an integrated rural health workforce pipeline that connects education, training, and employment to grow and retain Missouri’s healthcare talent locally, including efforts on: New entry points into health careers through high school, college, and training programs Expanding maternal and behavioral health training opportunities Clinical placement and retention supports across rural communities Tech and Data Interoperability Tech and Data Interoperability Create a statewide backbone for data interoperability that connects hubs, providers, and local partners to coordinate care, including: Community Information Exchange (CIE) for closed-loop referrals and shared care plans Data standards and compliance Public health connectivity Provider Transformation & Sustainability Provider Transformation & Sustainability Ensure the long-term financial, operational, and sustainable future of Missouri’s rural healthcare system through: Strategic infrastructure access modifications Alternative payment innovations Operational innovation and tech-enablement RHTP Hub Anchor Application 5/15/2026 Press Release: Missouri Department of Social Services Releases ToRCH Care Hub Boundaries Ahead of Hub Anchor Application 5/15/2026 Press Release: Missouri Department of Social Services Invites Rural Organizations to Apply as ToRCH Care Hub Anchors 12/29/2025: MHA applauds Missouri’s $216 million RHTP award 12/29/2025 Press Release: Governor Kehoe Secures More Than $216 Million to Strengthen Rural Healthcare in Missouri Rural Health Transformation Program (RHTP): A Guide for Stakeholders RHTP Application Narrative RHTP Application Summary Presentation Governor Kehoe's RHTP Endorsement Notice of Funding Opportunity Webinar, accessed October 15, 2025, https://www.

cms. gov/files/document/rht-program-applicants-webinar-presentation. pdf Rural Health Transformation Program Summary, accessed October 13, 2025, https://www.

ruralhealth. us/nationalruralhealth/media/documents/advocacy/2025/rural-health-transformation-program-summary. pdf Missouri Department of Social Services Invites Public Comment on Rural Health Transformation Program - GovDelivery, accessed October 13, 2025, https://content.

govdelivery. com/accounts/MODSS/bulletins/3ef7bd9 Invitation to Comment: Rural Health Transformation Program - myDSS - MO. gov, accessed October 13, 2025, https://mydss.

mo. gov/mhd/hot-tips/invitation-comment-rural-health-transformation-program Missouri Lawmakers Champion Rural Health, Unlocking Access to Quality Care for Rural Communities - Ways and Means Committee, accessed October 13, 2025, https://waysandmeans. house.

gov/2025/09/23/missouri-lawmakers-champion-rural-health-unlocking-access-to-quality-care-for-rural-communities/ Billions on the Table: Missouri Invites Public to Shape Rural Health Future - Missourinet, accessed October 13, 2025, https://www. missourinet.

com/2025/09/02/billions-on-the-table-missouri-invites-public-to-shape-rural-health-future/ Missouri Department of Social Services seeking public help in planning for rural health innovatio... - YouTube, accessed October 13, 2025, https://www. youtube.

com/watch? v=7B1VNbJueKc The $50 Billion Rural Health Transformation Program: What Providers Can Do Before Nov. 5, 2025, accessed October 13, 2025, https://www.

lara. health/blog/the-50-billion-rural-health-transformation-program-what-providers-can-do-before-nov-5-2025 Rural Health Transformation Program - Senate Finance Committee, accessed October 13, 2025, https://www. finance.

senate. gov/download/rural-health-transformation-program_fact-sheet A New Era for Rural Health in Missouri: Understanding the Rural Health Transformation Program The Rural Health Transformation Program (RHTP) is a landmark $50 billion federal investment designed to reshape healthcare in rural communities across America.

1 Established by Public Law 119-21, this five-year program is not a short-term grant but a significant opportunity to build a stronger, more sustainable healthcare system for the future.

1 In Missouri, the Department of Social Services (DSS), through its MO HealthNet Division, is leading the state's application effort in close collaboration with the Department of Health and Senior Services (DHSS) and the Department of Mental Health (DMH). 3 For questions about RHTP, email DSS. RHTP@dss.

mo. gov . ToRCH Care Hub Boundaries and Upcoming Hub Anchor Application DSS has released official county groupings for the local community “Hubs” that will form the backbone of Missouri’s Rural Health Transformation Program (RHTP).

RHTP is a national $50 billion fund created through the passage of H. R. 1 – One Big Beautiful Bill Act (OBBBA) on July 4, 2025.

A foundational element of Missouri’s program is a statewide network of healthcare “Hubs” designed to bring care closer to home, make clinical and non-clinical services more seamless, and ensure that no rural resident is left behind. Individual Hubs act as an organizing structure across ~3-5 counties made up of a variety of partners, including local hospitals, clinics, pharmacies, EMS, community-based organizations, and more.

Within a Hub, partners collaborate to understand and track local needs, coordinate care through connected referral systems, and implement programs targeted to improve community-specific needs. The newly released Hub boundary map reflects detailed analysis, stakeholder feedback, and the recent public comment period to ensure that each Hub represents a practical care ecosystem.

Please see the official Hub County groupings map below: click image to enlarge the map On May 15, a request for application (RFA) inviting rural healthcare organizations to apply to serve as Hub “Anchors” within these boundaries was released.

Hub Anchor organizations will serve as the neutral coordinator of their respective Hubs, hosting Hub staff supporting governance through a Leadership Board, and ensuring coordination workflows function effectively.

Missouri strongly encourages organizations to work collaboratively within their communities to determine the most appropriate Hub Anchor or consortium structure before applying to ensure shared ownership and collaborative alignment among rural providers. To learn more, please access the press release .

Request for Application (RFA): Rural Health Transformation Program Hub Anchors DSS has released an RFA inviting rural healthcare organizations to apply to serve as ToRCH Care Hub Anchors under Missouri’s Rural Health Transformation Program (RHTP). RHTP is a national $50 billion fund created through the passage of H. R.

1 – One Big Beautiful Bill Act (OBBBA) on July 4, 2025. A foundational element of the program is a statewide network of healthcare “Hubs” organizing healthcare partners across approximately 3-5 counties, designed to bring care closer to home, make clinical and non-clinical services more seamless, and ensure that no rural resident is left behind.

As the Hub Anchor, the selected organization serves as the neutral coordinator of this system, hosting Hub staff (including a Program Coordinator and Community Health Workers), supporting governance through a Leadership Board, and ensuring coordination workflows function effectively. Your leadership will help shape Missouri’s rural health care. Application deadline: June 18, 2026, at 11:59 P.

M. CT, submitted to DSS. RHTP@dss.

mo. gov Press Release: Missouri Department of Social Services Invites Rural Organizations to Apply as ToRCH Care Hub Anchors Webinar : May 19 at 11 A. M.

CT, Register to attend Application packet: Application details with required information from applicants and Hub / Hub Anchor context RHTP overview : Missouri’s Rural Health Transformation Program Overview.

Missouri strongly encourages organizations to work collaboratively within their communities to determine the most appropriate Hub Anchor or consortium structure before applying to ensure shared ownership and collaborative alignment among rural providers.

Upcoming Rural Health News DSS is inviting rural healthcare providers, community-based organizations, and other stakeholders to participate in a series of informational webinars supporting Missouri’s implementation of the Rural Health Transformation Program (RHTP), a major federal initiative designed to strengthen healthcare in rural communities.

As part of this effort, Missouri is launching Transformation of Rural Community Health (ToRCH) Care, the state’s coordinated model to enhance rural healthcare delivery and improve community outcomes. The webinar series will introduce the ToRCH Care model, outline opportunities for organizations to participate, and preview upcoming leadership roles within the program.

The upcoming webinar series will provide an overview of the ToRCH Care model and outline how organizations can participate, including opportunities to serve in leadership roles. There will be four webinars hosted over the next month. The webinars will include an informational section, dedicated time for Q&A, and a testimonial from current ToRCH pilot partners.

The following webinars are all scheduled on Wednesdays at 1:00 PM CT. The current webinar schedule includes: ToRCH Care program overview webinar Hospital-specific program deep dive Non-hospital clinical providers deep dive (e.g., FQHCs, RHCs, CCBHCs, EMS, pharmacies) Presentation Slides from 5/6/2026 Community institutions deep dive (e.g., CBOs, LPHAs) Register online for any webinars you are interested in.

Later webinars for Hub Anchor applicants will be held following the application release, expected early June. To learn more, please access the press release . Upcoming Rural Health Transformation Feedback and Procurement Opportunities The successful implementation of Missouri’s Rural Health Transformation (RHT) Program requires an intentionally collaborative planning process with stakeholders and partners.

This page provides information regarding upcoming and open opportunities for this collaboration – through both procurement as well as general feedback. New opportunities will be added to this page throughout the RHT project.

Upcoming RHT Request for Procurement (RFP) Opportunities Ambient AI Request for Information (RFI) Now Open The State of Missouri announces the release of a Request for Information (RFI) to gather input from Ambient Artificial Intelligence (AI) vendors to support healthcare providers under the Rural Health Transformation Program (RHTP).

The RFI is intended to identify solutions that improve care delivery in rural settings, reduce administrative burden for providers, and enhance patient outcomes across rural Missouri. Information gathered through this RFI will inform future procurement strategies and potential statewide deployment approaches.

Interested applicants can now access the request for information on the MissouriBuys, powered by MOVERS bid board, using the information below. Request for Information Number: # DSS 0000000005SL Request for Information Ends: June 01, 2026, 2:00 P. M.

CST MissouriBuys, powered by MOVERS bid board: https://missouribuys. mo. gov/bid-board Single Point of Contact (SPC): Steven Hoffman The State encourages all eligible organizations to carefully review the request for information materials, including instructions and requested forms.

To submit questions, please reference Section 2. 2 of the RFI available on MissouriBUYS. Responses to this RFI are voluntary and will be used for informational and planning purposes only.

Social Care Referral Platform / Community Information Exchange Quarter Three 2026 Due to updated Centers for Medicare & Medicaid Services (CMS) requirements related to the Rural Health Transformation Program (RHTP), the contract for Missouri’s SCR/CIE vendor must be finalized and executed no later than September 30, 2026. Adherence to this deadline is mandatory to retain federal RHTP funding for this award.

To meet this expedited timeline while ensuring a lowest and best value determination (per Section 34. 010, RSMo), the Department of Social Services (DSS) will utilize the National Association of State Procurement Officials (NASPO) ValuePoint cooperative purchasing agreements. This approach aligns with CMS’s emphasis on streamlined procurement and timely execution.

DSS plans to issue a Competitive Quote (CQ) to qualified vendors currently holding a master agreement under the NASPO Software VAR or NASPO Cloud contracts. The Competitive Quote document will outline: Detailed technical specifications for the SCR/CIE platform. Specific evaluation criteria and scoring weights.

Participation in required technical demonstrations tentatively scheduled for June 23-26, 2026. The responsive and qualified vendor achieving the highest total score based on the established evaluation criteria (including technical demonstration) will be recommended to DSS Leadership and to the DSS Director for approval. Only vendors with the legal authority to leverage NASPO Master Agreements in the State of Missouri will be considered.

Upcoming General Feedback Opportunities Remote Patient Technology Quarter Two 2026 The Rural Health Transformation Program information provided by the Missouri Department of Social Services is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $216,276,817. 66, with 100 percent funded by CMS/HHS.

The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CMS/HHS, or the U.S. Government.