Rural Health Transformation Program (RHTP) is sponsored by Missouri Department of Social Services. Funds systemic, long-term improvements to healthcare in rural communities across Missouri.

Rural Health Transformation | mydss. mo. gov Rural Health Transformation 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 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).

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).

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 Missouri Department of Social Services Invites Rural Organizations to Apply as ToRCH Care Hub Anchors Hub Anchor Application Webinar Recording Application details with required information from applicants and Hub / Hub Anchor context Navigator Job Description Hub Program Coordinator Job Description 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.

MO HealthNet Division invites providers to share input on APMs MO HealthNet Division has launched a survey to gather provider input on alternative payment models (APMs). The survey seeks feedback on providers’ past experiences with APMs, perceived challenges and benefits, and their readiness to implement these models.

It is intended for hospitals, FQHCs, primary care and multi‑specialty practices, and specialist groups, though any provider with APM experience may participate. Organizations that complete the survey may be invited to help shape future MO HealthNet APM initiatives. The survey , funded through the Rural Health Transformation Program (RHTP), is open to both rural and urban providers.

It will remain open through June 19 and should be completed once per organization. Support materials are available, and questions may be directed to DSS. RHTP@dss.

mo. gov . Complete the survey by June 19 to help inform Missouri’s approach to alternative payment models.

In May and June, team members from Missouri’s Rural Health Transformation Office launched the ToRCH Care Roadshows, a series of 12 in‑person sessions designed to connect directly with rural communities. The ToRCH Care Roadshows engaged rural healthcare providers, community organizations, and partners to strengthen collaboration and support improved access to care across Missouri. View the RHTP ToRCH Care Roadshow Handout .

View the RHTP ToRCH Care Roadshows Frequently Asked Questions . DSS invited 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).

Missouri is launching Transformation of Rural Community Health (ToRCH) Care, the state’s coordinated model to enhance rural healthcare delivery and improve community outcomes. There were four webinars hosted from April to May 2026. The webinars included an informational section, dedicated time for Q&A, and a testimonial from current ToRCH pilot partners.

The presentations of the webinars are available below.

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) Upcoming RHT Request for Procurement (RFP) Opportunities Social Care Referral Platform / Community Information Exchange Quarter Three 2026 In order to meet CMS deadlines 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. Only vendors with the legal authority to leverage NASPO Master Agreements in the State of Missouri will be considered.

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 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 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 County Groupings and RCNs Map ToRCH Care Roadshow Slides - Spring 2026 Hub Specific Statistics - Spring 2026 Roadshow Slides Roadshows Frequently Asked Questions RHTP Hub Anchor Application Navigator Job Description Hub Program Coordinator Job Description 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 Background Information Background Information 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.

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gov/download/rural-health-transformation-program_fact-sheet Item Date / Deadline Status Action Alternative Payment Models Survey Open until June 19, 2026 Survey Open View Press Release Hub Anchor Application Due Open until June 18, 2026 Application Open View Press Release Download Application Packet Navigator Job Description Hub Program Coordinator Job Description Hannibal Virtual Roadshow 6/4/2026 Completed Watch Recording Sedalia Virtual Roadshow 6/3/2026 Completed Watch Recording Rolla Virtual Roadshow 6/2/2026 Completed Watch Recording Ambient AI Request for Information (RFI) 6/01/2026 Closed Posted on Missouribuys West Plains Virtual Roadshow 5/27/2026 Completed Watch Recording Branson Virtual Roadshow 5/27/2026 Completed Watch Recording RHTP ToRCH Care Roadshows May-June 2026 Completed View Presentation Slides Hub Anchor Application Webinar April 17, 2026 Completed Watch Recording ToRCH Care Hub Anchor Application Released 5/15/2026 Posted View Press Release Download Application Packet Navigator Job Description Hub Program Coordinator Job Description ToRCH Care Hub Boundaries Map Released 5/15/2026 Available View Press Release ToRCH Care Community Institutions Webinar 5/13/2026 Completed Watch Recording ToRCH Care Non-Hospital Clinical Providers Webinar 5/6/2026 Completed View Presentation Slides ToRCH Care Hospital Specific Webinar 4/29/2026 Completed Watch Recording Invitation for Bid for Vital Rural Hospital Repairs 4/27/2026 Posted View Press Release ToRCH Care Overview Webinar 4/22/2026 Completed Watch Recording Digital Readiness Survey 4/17/2026 Closed Results Pending RHTP Year One Budget Approved 4/7/2026 Approved View Press Release View Year One Fund Distribution Public Comment Invited on RHTP 8/26/2025 Completed See Press Release MHA applauds Missouri’s RHTP award 12/29/2026 Posted See Press Release Governor Kehoe Secures More Than $216M 12/29/2026 Posted See Press Release RHTP Application Materials 11/2025 Submitted RHTP Application: A Guide for Stakeholders RHTP Application Narrative RHTP Application Summary Presentation Governor Kehoe's RHTP Endorsement 10/31/2026 Posted See Press Release 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.