COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

ONE ASHBURTON PLACE, 11th FLOOR

BOSTON, MA 02108

Request for Applications For EOHHS Rural Health Transformation Program (RHTP) Rural Partners Document ID#: 27EHSCARHTPRURALPARTNERSRFA Issue Date: October 6, 2026

TABLE OF CONTENTS

ATTACHMENTS

Attachment A: RHTP Rural Partner Application Attachement B: Partnership Validation Form Attachment C: MA DPH Rural Definition - Rural Town & Cluster List

RFA - EOHHS Rural Health Transformation Program (RHTP) Rural Partners 2

Purpose of Procurement The Massachusetts Executive Office of Health and Human Services (EOHHS) is issuing this Request for Applications (RFA) to invite qualified rural entities to participate in the implementation of the Massachusetts Rural Health Transformation Program (RHTP). RHTP represents a landmark $800 million, five-year investment by the federal government to strengthen access to healthcare, improve population health, and advance long-term health and well-being across rural Massachusetts. Eligible rural-located facilities, providers, municipalities, and community organizations seeking RHTP technical assistance, planning support, program participation, and direct funding are encouraged to apply.

The program will be implemented through a coordinated interagency partnership led by EOHHS, with participation from the Massachusetts Department of Public Health (DPH), MassHealth, DPH’s State Office of Rural Health, the Massachusetts Executive Office of Economic Development’s Office of Rural Affairs, and other state agencies. Together in partnership with rural entities, these partners will support implementation of RHTP activities designed to address the unique needs of rural communities and strengthen the systems, services, and partnerships that support rural health.

Selected entities will support the Rural Health Transformation goals of ensuring rural residents can access needed healthcare services; generating opportunities to improve the health and well-being of rural residents; and scaling systems, policies, and investments to meet the unique needs of rural communities.

Through this procurement, eligible entities will be able to apply for a range of supports, including technical assistance, planning and implementation support, and direct grant funding for activities across the RHTP. The RHTP is organized across seven Initiatives and 34 Activities designed to address priority needs in rural healthcare access, population health, workforce, technology, community health, emergency medical services, and facility modernization. This RFA provides eligible applicants with the opportunity to seek support for activities across six of the seven RHTP Initiatives and certain Activities. Initiative 5, Emergency Medical System (EMS) Service Integration, as well as certain other Activities are not included in this RFA.

Rather than requiring organizations to navigate multiple separate funding opportunities, this procurement provides a common entry point for participating entities to identify their needs and apply for the types of support most appropriate to their organization, community, and needs. Types of support and eligible entities are detailed below by each activity area. These supports include organizational or community assessments, program planning, technical assistance, implementation assistance and funding, capacity building and training, technology or infrastructure investments, as well as direct funding to establish, expand, or strengthen rural health programs and services.

The procurement is intended to reduce administrative burden on rural organizations while supporting coordinated implementation across the RHTP’s initiatives. Investments will prioritize approaches that respond to local rural needs, strengthen partnerships and organizational capacity, expand access to care and community-based support, and create sustainable improvements that can continue beyond the RHTP funding period. This reflects the program’s broader emphasis on combining direct investment with technical assistance and capacity building so rural entities have both the resources and the support necessary to successfully plan, implement, and sustain transformation activities.

This RFA 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 $162,005,238.13 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.

Background Massachusetts’ rural communities face persistent barriers to healthcare and social services, and therefore higher rates of several chronic conditions, due to the challenges of geographic isolation, transportation limitations, workforce shortages, limited primary and specialty care access, higher chronic disease burden, aging infrastructure, and financial pressures on rural providers. In addition, many rural organizations lack the staffing, technology, and resources needed to expand services and coordinate care effectively.

The Massachusetts Rural Health Transformation Program (RHTP) is designed to address these challenges through three overarching goals: ensure rural residents can readily access healthcare services; generate opportunities to improve the health and well-being of rural residents; and scale systems, policies, and investments to meet the unique needs of rural communities.

To advance these goals, the RHTP uses strategies focused on strengthening rural providers and workforce, improving chronic disease prevention and management, expanding innovative and technology-enabled care models, increasing coordination across clinical and community systems, and investing in sustainable infrastructure and payment approaches. These strategies are organized across seven initiatives: Population Health Advancement; Innovation in Rural Care Models; THRIVE Workforce; Healthy Rural Communities; EMS Service Integration; Enhancing Technology Interoperability and Connectivity; and Facility Modernization and Re-Use.

Eligible Entity Definitions For purposes of this funding opportunity, the following definitions will generally apply. Final eligibility will be determined by EOHHS based on the specific requirements of each Activity and the Massachusetts RHTP rural definitions and facility lists.

Emergency Medical Services (EMS) / Ambulance Provider: A licensed municipal, nonprofit, hospital-based, or other ambulance or EMS organization serving rural communities. Specific Activities may further limit eligibility to rural-located EMS entities or EMS agencies serving designated rural municipalities.

Rural Health Clinic (RHC): A clinic designated and certified as a Rural Health Clinic by CMS and located in a qualifying rural and underserved or shortage area. RHCs may be provider-based or independent and use a team-based model that includes physicians and non-physician practitioners. The CMS-approved Massachusetts RHTP application listed six eligible RHCs: Tully Family Medicine, Athol Primary Care, Martha’s Vineyard Rural Clinic, East Mountain Medical, Nantucket Primary Care, Williamstown Medical at North Adams, and Williamstown Medical.

Rural Hospital: A hospital identified as rural for purposes of the Massachusetts Rural Health Transformation Program. This includes designated Critical Access Hospitals (CAHs) and rural Prospective Payment System (PPS) hospitals that meet applicable CMS, Federal Office of Rural Health Policy, and/or Massachusetts rural hospital criteria. The CMS-approved Massachusetts RHTP application listed six eligible rural hospitals: Athol Hospital, Martha’s Vineyard Hospital, Fairview Hospital, North Adams Regional Hospital, Nantucket Cottage Hospital, and Baystate Wing Hospital.

Rural-Located Community-Based Organization (CBO)/ Social Service Organization (SSO): An organization with a physical presence in a designated rural community and a demonstrated role serving rural residents by providing health promotion, food and nutrition assistance, aging and disability services, family support, transportation, housing, care navigation, social services, economic, behavioral, or other community supports. This includes nonprofit, community-based, faith-based, or other locally rooted organizations as well as regional planning agencies. This also includes behavioral health organizations and opioid treatment programs, in addition to those listed above, that meet applicable state licensing, certification, or program requirements and providing community-based mental health and related services to rural communities.

Rural-Located or Rural-Serving Federally Qualified Health Center (FQHC): An organization that is a Health Resources and Services Administration Health Center Program award recipient and is certified by CMS. Federally Qualified Health Centers or Public Health Service Act Section 330 Grantees are considered rural-located if they are located in a rural area based on the most recent version of the rural definition maintained by HRSA. The CMS-approved Massachusetts RHTP application listed four eligible rural-located FQHCs that represent ten rural sites: Community Health Programs, Community Health Center of Franklin County, Outer Cape Health Services, and Island Health.

EOHHS has determined that a rural-serving FQHC must have served over 5,000 patients in 2023 from a rural community, as set forth in the CMS-approved Massachusetts RHTP application, in order to be eligible for RHTP technical assistance, planning and implementation support, or direct grant funding. Information used to determine if a facility meets the minimum patient utilization criterion for Federally Qualified Health Centers was sourced from HRSA’s Health Center Program GeoCare Navigator. There are three eligible rural-serving FQHCs that represent eight rural sites: Community Health Programs, Community Health Connections and Hilltown Community Health Centers.

Rural-Located Healthcare Provider or Practice: A healthcare provider, practice, clinic, or service site physically located in a municipality designated by DPH as rural. Depending on the Activity, eligible providers or practices may include primary care, behavioral health, specialty care, dental, maternal health, home-based care, rehabilitation, or other health services, including Opioid Treatment Programs, and Community Behavioral Health Centers.

The CMS-approved Massachusetts RHTP application listed four eligible rural-located Community Behavioral Health Centers (CBHC): Community Support Options (two sites), Martha’s Vineyard Community Services, and Fairwinds Center. It also identified the eligible rural-located Opioid Treatment Programs (OTP): Behavioral Health Network (two sites), Healthcare Resource Centers, and Spectrum Health Systems (two sites).

Rural-Located Nursing Facilities: A nursing facility physically located in a municipality designated by DPH as rural. There are 15 eligible rural-located nursing facilities: Advinia Care at Provincetown, Fairview Commons Nursing and Rehabilitation Center, Timberlyn Heights Nursing and Rehabilitation, Kimball Farms Nursing Care Center, Mount Carmel Care Center, North Adams Commons Nursing and Rehabilitation Center, Berkshire Rehabilitation and Skilled Care Center, Williamstown Commons Nursing and Rehab, Windemere Nursing and Rehabilitation Center, Charlene Manor Extended Care Facility, Poet’s Seat Healthcare Center, Regal Care at Greenfield, Our Island Home, Quaboag Rehabilitation and Skilled Care Facility, Quabbin Valley Healthcare, and Lee Healthcare.

Rural Municipality: A Massachusetts city or town designated as rural under the applicable Massachusetts State Office of Rural Health/RHTP rural definition.

Rural Partner Eligibility and Application Types Eligible entities vary by Activity and are identified within each Activity description. Applicants should review the eligibility requirements for each Activity area before applying. Unless otherwise specified, an organization must meet the applicable rural location, facility type, provider type, or rural-serving criteria described below. Based on funding and other considerations, eligibility for some Activities may be expanded in future years to include different entity types or regions. At that time, EHS anticipates that there will be separate procurement processes to identify organizations to provide subject matter expertise and technical assistance for Activities. This may allow non-rural organizations to participate as partners, vendors, educational institutions, specialty providers, or technical assistance entities where their participation directly supports services or infrastructure for rural communities. Applicants may apply for multiple activity areas.

For Activities that require an applicant, facility, or service location to be rural-located, eligibility will be based on the Massachusetts Department of Public Health State Office of Rural Health’s rural definition. The Massachusetts RHTP uses this definition, which classifies communities by level of rurality and organizes rural communities into regional clusters. See Attachment C: MA DPH Rural Definition - Rural Town & Cluster List.

Rural Partner Participation Administrative Requirements Federal funds will be used to fund all activities.

Vendor Coordination and Support State-contracted managing vendors procured through separate procurement actions will coordinate directly with selected entities to support implementation of funded activities and facilitate access to both direct funding and technical assistance. Vendors may serve as the primary point of coordination for onboarding, workplan development, funding administration, technical assistance scheduling, reporting expectations, and ongoing implementation support. Vendors will work with participating organizations to identify barriers, connect them to appropriate subject matter expertise and resources, and help ensure that financial and technical supports are aligned with approved project goals, timelines, and local needs. This structure is intended to reduce administrative burden on participating organizations while providing hands-on support throughout planning and implementation.

Direct Funding Information Direct Funding amounts will be determined following the review of submitted applications. Award amounts will take into consideration the number and scope of eligible applications received, available funding within each RHTP activity, program priorities, community and organizational need, and the level of funding necessary to support successful implementation. EOHHS may adjust individual award amounts to ensure that available resources are distributed in a manner that advances RHTP goals, supports geographic and programmatic balance, and responds to identified needs Grantees receiving federal grant funds will be considered sub-recipients for federal grant purposes and will be required to comply with applicable federal requirements, including but not limited to, sub-recipient audit requirements under OMB Circular A-133.

The funds received in advance of expenditure by a grantee for a capital budget item must be held in a segregated non-interest-bearing account and must be expended within 60 days (for policy information on spending capital funds see: Office of the State Comptroller, State Grants and Federal Sub-grants):

https://public.powerdms.com/MAComptroller/documents/1778986 Grantees receiving federal grant funds will be responsible for maintaining appropriate administrative, fiscal, and programmatic systems to support implementation of funded activities and compliance with all applicable Rural Health Transformation Program requirements. Awardees must maintain complete and accurate records, cooperate with EOHHS and its designated contractors or technical assistance providers, participate in required meetings and monitoring activities, and provide timely information necessary to support state and federal reporting. Applicable federal award requirements and terms and conditions may flow down to participating subrecipients.

Fiscal Monitoring Direct funding awardees must maintain financial management and accounting practices sufficient to document the receipt and use of RHTP funds and demonstrate that expenditures are consistent with the approved budget, scope of work, and applicable program requirements. Awardees will be expected to track expenditures, maintain appropriate supporting documentation, and submit periodic fiscal reports in a format and schedule established by EOHHS. CMS expects financial reporting to be supported by established accounting practices and to provide a transparent, auditable record of obligations, payments, and expenditures.

Managing vendors and other designated technical assistance partners may work directly with awardees identified as needing additional support to strengthen fiscal management practices, establish appropriate tracking and documentation processes, understand reporting requirements, and address identified gaps. Fiscal monitoring may therefore include both oversight and, where appropriate, technical assistance intended to help organizations successfully meet program requirements. EOHHS may conduct periodic fiscal reviews, request supporting documentation, reconcile reported expenditures, and require corrective action when significant concerns or discrepancies are identified.

Performance Monitoring All selected participants will be expected to demonstrate progress toward the activities, deliverables, milestones, and performance measures established in their activity. Performance monitoring may include periodic progress reports, participation in monitoring or technical assistance meetings, submission of quantitative and qualitative data, documentation of individuals or communities served, progress toward identified milestones and outcomes, identification of implementation barriers, and supporting documentation demonstrating completion of key activities. EOHHS may use performance information to identify technical assistance needs, support continuous quality improvement, assess satisfactory progress, and inform decisions regarding continued or future funding.

Anticipated Term of Participation

1. The Massachusetts Rural Health Transformation Program (RHTP) is a five-year program designed to support sustained transformation of rural healthcare delivery, infrastructure, workforce, and community health. This application is for participation in selected RHTP Activities during the period of October 30, 2026, through September 30, 2027.

Organizations selected through this procurement will be expected to participate in applicable planning, implementation, technical assistance, monitoring, and reporting activities during this initial participation period.

Participation in future years of the five-year RHTP is not guaranteed through this application. Opportunities to participate in subsequent program years are anticipated to be made available through a new procurement process in 2027, subject to available funding, program priorities, federal requirements, and continued implementation of the Massachusetts RHTP. Organizations participating in the 2026–2027 period may be eligible to apply for future opportunities but will be required to respond to any applicable future procurement.

Application Requirements Eligible applicants must submit a completed Attachment A: the RHTP Rural Partner Application, and complete all required sections for each Activity for which they would like to be considered. Applicants may apply for one or more eligible Activities through the same application, provided all required Activity-specific questions and supporting information are completed. If applicants have an existing partnership that would participate in one of the Activities for which they have applied, they must also submit a completed Attachment B: RHTP Partner Validation Form for each named partner in their application.

Applications must be submitted by email to EOHHS-Procurement@mass.gov no later than 5:00 PM ET on Monday, October 26, 2026. Please include “RHTP Rural Partner Application” in the email subject line. The submission must include the completed application PDF and any required attachments or supporting documentation identified in the application or applicable Activity instructions. Hard copy submissions will not be accepted. Applications received after the submission deadline may not be considered.

Applicants will receive an email confirming receipt of their submission from COMMBUYS. Applicants are responsible for ensuring that all required application materials and attachments are complete and successfully transmitted by the deadline.

Questions regarding this application may be submitted by email to EOHHS-Procurement@mass.gov no later than 5:00 PM ET on Wednesday, October 14, 2026. Responses to submitted questions may be compiled and shared with prospective applicants through the COMMBUYS posting. Applicants are encouraged to submit questions as early as possible and should not wait until the application deadline to raise issues that may affect eligibility or submission requirements.

The Bid Solicitation Q&A functionality in COMMBUYS will be also used for this RFA; emailing Bidder questions to the RFA Contact Person is preferred. EOHHS will not be responding to questions individually on COMMBUYS. Any written response to questions will be compiled and posted on COMMBUYS in a document.

Description of Program

1. Eligible Entities Table

Facility Modernization and Re-use – Initiative 7

Description of Activities Initiative 1 – Population Health Advancement Activities

1.1 Chronic Disease Management Networks

Eligible Entities: Rural Hospitals, Rural FQHCs, RHCs, Rural-Located Primary Care Providers and Practices, Rural-Located CBOs/SSOs, Rural Municipalities.

Activity Purpose: This Activity area will support rural regions to build sustainable chronic disease management (CDM) networks by connecting interested local organizations, facilitating planning and coordination, identifying organizational roles in the network, establishing legal and data-sharing agreements, designing chronic disease management workflows, providing training and technical support, piloting approaches, establishing the best fit model, and developing sustainability road maps.

Year One Funding: Selected eligible entities will be eligible to receive direct funding to support staff coordination and participation in the planning and implementation of CDM networks. Technical assistance provider(s) will coordinate facilitation and planning activities to support the design and implementation of CDM networks. Funding will also support locally identified needs for Equipment and Consulting Supports. Examples of types of equipment and support that could be funded: legal and data sharing agreements, software products, screening tools.

Priority Areas: In Year One, we plan to focus efforts on regions with the greatest chronic disease disparities. These prioritized rural cluster regions include North Central, Southern Berkshires, Central Berkshires, East Quabbin, Northern Berkshires, North Quabbin, Lower/Outer Cape, and Quaboag Valley. Priority will also be given to organizations who also plan to participate in Activities 1.2 Rural MA Connect and 1.5 Remote Patient Monitoring.

Who Should Apply to Join the Planning Process: Eligible entities have a role in preventing, managing, or coordinating care for chronic disease are encouraged to apply to participate in the planning process. This includes eligible entities with experience supporting individuals with diabetes, hypertension, heart disease, COPD, cancer, or other chronic conditions. Applicants do not need to have an existing chronic disease management program; there is particular interest in organizations that want to collaborate to shape a regional approach, identify service gaps and community needs, clarify partner roles, and identify a model where clinical, community, and social supports can work together as a sustainable chronic disease management network.

Intersections with other Activities: This Activity will have intentional connection and coordination with Activities 1.2, 1.5, 1.6, 1.8, 2.1, 4.1, and 4.4.

1.2 Rural MA Connect

Eligible Entities: Rural Hospitals, Rural FQHCs, RHCs, Rural-Located Primary Care Providers and Practices, and Rural-Located CBOs/SSOs.

Activity Purpose: This Activity will develop Rural MA Connect, a bi-directional technology and coordination platform designed to connect healthcare, social service, and community-based organizations. The platform will support electronic referrals, data sharing, real-time resources, closed-loop referral tracking, coordinated care workflows, and improved communication between clinical and community partners. Year One will focus on working with rural organizations and other stakeholders to define platform requirements, governance, workflows, data-sharing needs, and implementation priorities. The goal is to build infrastructure that reduces fragmentation, makes it easier for providers and community organizations to connect rural residents with needed services, and supports more coordinated care across healthcare and social service systems. Planning will also explore opportunities for EHR integration, care management functions, billing support, and connections with other Rural Health Transformation Program activities.

Year One Funding: Year One funding will support Rural MA Connect planning and design, including procurement strategy, stakeholder engagement, governance, workflow development, and technical planning. Rural organizations will help define referral workflows, data-sharing needs, and implementation priorities. Direct funding to rural organizations is anticipated in future years to support implementation, training, technology integration, and network participation, with technical assistance and consulting support available throughout the process.

Who Should Apply: Eligible entities that regularly refer residents to other services, receive referrals from partner organizations, provide care coordination or navigation, or experience challenges related to fragmented referral and information-sharing systems are encouraged to participate. Organizations do not need to have advanced technology infrastructure or an existing electronic referral platform to participate. Rural organizations that currently rely on manual referrals, phone calls, fax, spreadsheets, or disconnected systems are especially important to the planning process so that Rural MA Connect is designed around the practical needs and capacity of all rural providers and community organizations.

Intersections with Other Activities: Rural MA Connect will serve as a shared referral, communication, and coordination infrastructure that can support multiple Rural Health Transformation Program activities. It will have particularly strong connections with 1.1 Chronic Disease Management Networks, 1.5 Remote Patient Monitoring, 1.6 Home Visiting, 1.8 Value-Based Payments, and 2.2 Integrated Specialty Care Networks.

1.3 Massachusetts Youth Care: Closer to Home (MY Care)

Eligible Entities: Rural Hospitals, Rural FQHCs, RHCs, Community Behavioral Health Centers, other Rural-Located Healthcare Providers and Practices, and Rural-Located CBOs/SSOs and other rural organizations involved in identifying, referring, coordinating, stabilizing, transitioning, or delivering behavioral and/or medical health care are encouraged to identify MY Care as an area of interest. In Year One, MY Care will prioritize rural providers that deliver out-of-home or residential care to youth and young adults.

Activity Purpose: This Activity will support the development of a coordinated rural care model designed to better connect youth and young adults with complex behavioral health, developmental, and medical needs to appropriate services closer to home. MY Care will integrate rural programs and providers into a statewide, cross-agency system and establish a flexible “no wrong door” digital access and coordination model that improves visibility into available services and provider capacity, supports better matching and referrals, and enables more coordinated care across agencies and providers. This will support the development of a portable youth profile and shared coordination infrastructure, improve real-time visibility into service demand and capacity, strengthen closed-loop referrals and outcome tracking, and help rural providers more flexibly respond to changing community needs. MY Care will seek to better align and streamline various processes and data across systems while reducing administrative burden on rural providers.

Year One Funding: In Year One, selected rural out-of-home and residential care providers may receive direct funding, technical assistance, equipment, and specialized consulting support to help design and launch regional MY Care networks. Direct funding may support staff time and coordination, provider co-design, workflow and referral development, data and technology readiness, regional planning, and other approved implementation needs. Regional networks may be established in rural clusters. Each regional network will be eligible to receive up to $100,000 in direct funding in Year One subject to final program design, selection, and available funds to support planning and coordination in addition to technical assistance, equipment, and specialized consulting support.

Priority Areas: Year One will focus on co-designing and launching the initial MY Care model with rural out-of-home and residential care providers and establishing regional networks across 12 rural clusters.

Who Should Apply: Rural-Located Healthcare Providers and Practices of out-of-home or residential care for youth and young adults with complex needs are encouraged to apply for Year One funding and implementation participation.

Rural Hospitals, Community Behavioral Health Centers, Rural FQHCs, RHCs, and other rural organizations involved in identifying, referring, coordinating, stabilizing, transitioning, or delivering care are encouraged to identify MY Care as an area of interest. These organizations may participate in planning and may be considered for technical assistance, equipment, consulting support, or future funding opportunities.

Participation opportunities are expected to expand during the five-year Activity as the model, infrastructure, and regional capacity develop.

Intersections with Other Activities: MY Care will coordinate with related activities that strengthen the clinical, specialty-care, telehealth, and digital infrastructure needed to support youth and young adults, including:

· Activity 2.2: Integrated Specialty Care Networks

· Activity 2.3: Telehealth Expansion

· Activity 2.4: Rural Digital Health Sandbox

1.5 Expand Remote Patient Monitoring (RPM) Programs

Eligible Entities: Rural Hospitals, Rural FQHCs, RHCs, and Rural-Located Primary Care Providers and Practices. Rural-Located EMS and Rural-Located CBOs/SSOs are also encouraged to join local planning conversations to support regional coordination and implementation.

Activity Purpose: This Activity will support rural healthcare providers in expanding the use of Remote Patient Monitoring (RPM) to strengthen chronic disease prevention and management, extend the reach of primary care, and improve access to care for rural residents. Participating organizations will receive support to assess readiness for RPM, identify appropriate patient populations and clinical use cases, develop operational workflows, establish technology and monitoring infrastructure, train staff, and implement or expand RPM programs. Initial efforts are expected to focus on chronic conditions where ongoing monitoring can support earlier intervention, improve disease management, and reduce avoidable reliance on emergency department, inpatient, and other facility-based care. This Activity is intended to take broad approach by purchasing equipment, building provider capacity, addressing identified barriers, and ensuring rural organizations can incorporate RPM into routine care delivery.

Year One Funding: Year One will focus on establishing foundational infrastructure and provider capacity needed to expand RPM in rural communities. Activities will include convening partners, identifying organizational roles, exploring rural RPM network approaches, developing training resources, and defining direct technical and financial support for participating providers. Participating entities will be eligible to receive direct funding of up to $200,000 in addition to technical assistance and consulting support to facilitate RPM planning, training, infrastructure development, and initial implementation.

Priority Areas: For Year One, priority consideration will be given to organizations who are also participating in any of the following activities: 1.1 Chronic Disease Management Networks, 1.6 Home Visiting Programs, 1.7 Hospital at Home Programs, or 5.1 Expanding Mobile Integrated Health.

Who Should Apply: Rural Hospitals, FQHCs, RHCs, and Rural-Located Primary Care Providers and Practices that are interested in implementing or expanding RPM are encouraged to apply. Organizations may be at different stages of readiness and do not need to have an existing RPM program to participate. Organizations should serve patient populations with chronic disease and be willing to assess how RPM could strengthen prevention, disease management, care coordination, and access within their service area. Applicants should be prepared to engage in clinical, operational, and technological leadership; participate in planning, training and technical assistance; develop program workflows and sustainability plans; and evaluate how RPM can be incorporated into existing care delivery models. Rural-located EMS and CBOs/SSOs are also encouraged to join local planning conversations to support regional coordination and implementation.

Intersections with Other Activities: This Activity will have intentional coordination with 1.1 Chronic Disease Management Networks, 1.6 Implement New Home Visiting Programs, 1.7 Hospital at Home Programs, and 5.1 Mobile Integrated Health.

1.6 Implement New Home Visiting Programs

Eligible Entities: Rural Hospitals, Rural FQHCs, RHCs, Rural-Located Healthcare Providers and Practicers, Rural-Located CBOs/SSOs.

Activity Purpose: This Activity will develop a coordinated rural home visiting system with sustainable infrastructure to provide evidence-based or evidence-informed family support, health assessment, chronic disease prevention and management, care coordination, education, and health navigation across the lifespan. The goal is to expand access to home- and community-based services for rural residents, including families with young children, pregnant and postpartum individuals, older adults, caregivers, and people living with chronic conditions. Year One will include a needs assessment and gap analysis to identify existing resources, service gaps, priority populations and geographies, workforce and infrastructure needs, and the home visiting models best suited to the various regions. The Activity will also strengthen connections between home visiting programs and the broader rural health system through coordinated referral, communication, and care pathways with primary care, hospitals, behavioral health, Mobile Integrated Health, and other health and community partners.

Year One Funding: Year One will focus on designing an effective and sustainable rural home visiting system through a needs assessment and gap analysis. The assessment will identify existing programs and infrastructure, geographic and population gaps, priority evidence-based or evidence-informed models, workforce and training needs, technology and data requirements, and opportunities to strengthen chronic disease management, referrals, and care coordination. Participating organizations will receive direct funding support to participate in assessments. After the assessment, organizations selected to expand existing program models and/or implement new models will receive direct funding to support delivery of home visiting services to rural residents. Funding can support infrastructure, staffing coordination, training, referral development, data and reporting readiness, and other program start-up needs. Final award structures may be adjusted based on identified community needs, geographic priorities, service models, and organizational capacity.

Who Should Apply: Rural Hospitals, Rural FQHCs, RHCs, Rural-Located Healthcare Providers and Practicers, and Rural-Located CBOs/SSOs that are interested in implementing or expanding home visiting services are encouraged to apply. Preference will be given to organizations that are already providing home-based services or have established experience delivering services in the home. Applicants should be willing to participate in training, technical assistance, data collection, quality improvement, and coordination with healthcare and community partners.

1.7 Hospital at Home

Eligible Entities: Rural Hospitals for Year One.

Activity Purpose: The Activity will support rural hospitals in developing Hospital at Home models that are appropriate for their organization and rural service area, with the goal of expanding access to hospital-level care closer to home, improving patient choice, and reducing reliance on facility-based care. Participating hospitals will receive support to assess organizational and regional readiness, identify operational and service gaps, develop implementation plans and standard operating procedures, identify necessary clinical and non-clinical partners and vendors, address workforce and technology needs, and prepare applications for applicable CMS Hospital at Home waivers.

Year One Funding: Rural Hospitals will be eligible to receive direct funding to support participation in Hospital at Home planning and initial implementation activities. A technical assistance provider will support participating hospitals through the planning and implementation process. Technical assistance will include organizational and regional readiness assessments and gap analyses; identification and planning for required vendors, services, workforce, equipment, and supplies; identification of technology, clinical monitoring, pharmacy, diagnostic, transportation, and other operational needs; and as appropriate development of implementation plans or identification of a model supported by others.

Who Should Apply: The six identified rural hospitals are encouraged to participate to support planning and designing the model that would work best for their service area. Rural hospitals will explore whether the model is operationally or financially feasible for their organization. Hospitals should be willing to actively participate in a structured readiness assessment and planning process, engage clinical and operational leadership, identify internal and external partners, explore opportunities to coordinate with other Rural Health Transformation Program activities, and work toward Hospital at Home implementation when organizational readiness and federal requirements allow.

1.8 Develop Rural Value-Based Payment Models

Eligible Entities: Rural Hospitals for Year One. Eligibility may expand to additional rural entities in future years based on program design and funding availability.

Activity Purpose: This Activity will support the development of a new funding program for rural hospitals focused on population health, value-based care, and financial sustainability. Participating hospitals will also receive technical assistance to strengthen their capacity to participate successfully in value-based payment arrangements and other incentive programs. Year One will focus on assessing hospital and regional readiness, identifying opportunities for new payment approaches, and engaging rural hospitals in the design of future value-based programming.

Year One Funding: Participating rural hospitals will receive coordinated technical assistance and implementation support to prepare for value-based payment models. Support may include baseline population health assessments; identification of key utilization, quality, and disease burden measures; assessment of current participation in incentive and payment programs; identification of opportunities for new financial incentives; education and coaching on value-based contracting, quality reporting, population health management, financial sustainability; data analytics, quality improvement, and performance measurement support. Hospitals may also receive direct funding to support participation in readiness activities and submission of baseline data needed to inform program design.

Who Should Apply: All six rural hospitals are encouraged to participate. Participating hospitals will provide input into payment program design, engage in organizational and regional readiness assessments,…