Note: Year 2 numbers are out and state budget revisions are due to CMS in three weeks, so expect plans to get reshuffled before Thanksgiving. RHTP Verified Intelligence tracks every one of those moves.
In this issue:
CMS announces $10 Billion in Second Year of Rural Health Transformation Awards to All 50 States, and no state moves more than 4%
North Carolina posts Medicaid Primary Care Capitation Pilot FAQs: rural members, not rural offices, decide eligibility
North Dakota moves Childcare for the Rural Health Workforce and Non-Emergency Medical Transportation Acquisition to Awarded
Oregon says 2027 money goes mostly to Year 1 grantees, and its new rural hospital network is run by the same firm as Ohio’s
Oklahoma confirms a $227,097,542.59 Budget Period 2 award, and OSU’s Technology Cooperative shows up on USAspending at $12,623,352
Utah gives USU Extension over $1 million from the Utah Food Security Grant to build e-commerce websites for farmers
Maine opens the RHTP Community Health Worker (CHW) Initiative Request for Applications, $110,000 per award, due November 30
West Virginia opens Water Is Medicine, $3.2 million for McDowell and Mingo Counties, due November 20
CMS announces $10 Billion in Second Year of Rural Health Transformation Awards to All 50 States, and no state moves more than 4%
Announced November 9. On November 6 we reported CMS had released the $100 million base and held back the competitive share. This is the competitive share. $20 billion of the $50 billion is now awarded.
New Jersey at $142,338,224 to Texas at $281,976,026, the same bottom and top as Year 1. 25 states went up, 25 went down, and no total moved more than 3.7%.
Up most: North Dakota +$7,442,657; Iowa +$6,967,593; Montana +$6,231,310; Virginia +$6,165,230
Down most: Florida -$6,110,124; Vermont -$5,057,704; New Jersey -$4,912,582; New York -$4,308,137
Kevin Richert of Idaho Education News called Idaho’s $3,275,991 drop inexplicable. CMS’s own State Data Maps, updated with the Year 2 numbers, point to the answer. CMS rescores two things each year, initiative progress and state policy actions. On initiatives, Idaho’s five sit at Stage 1 complete, with most of the country. On policy, Idaho committed to none. So did Florida, New Jersey, New York and Washington. Of the 13 states with zero commitments, 11 lost money. Of the 14 with four or more, 12 gained.
North Dakota has five, including the two CMS singled out, the Presidential Fitness Test and nutrition CME, which it passed in January. The fact sheet adds that July obligation data “do not, by themselves” set a state’s award, so obligating early didn’t save Idaho.
North Carolina posts Medicaid Primary Care Capitation Pilot FAQs: rural members, not rural offices, decide eligibility
We walked through the design deck October 19. Last night Northwest AHEC’s Practice Support team posted an FAQ. NC AHEC Practice Support is the contracted technical-assistance vendor for the pilot. The FAQ adds four things:
A practice outside a rural county can qualify if enough of its assigned Medicaid members live in rural areas. NCDHHS is still setting the minimum share
Phase 1 requires at least Advanced Medical Home Tier 2. FQHCs, look-alikes and Rural Health Clinics wait for a possible phase 2. Local health departments are undecided
The per-member-per-month payment (PMPM) covers office visits, preventive screenings, telehealth and home visits. Vaccine administration, lab, maternity services and less predictable procedures stay fee-for-service
Capacity-building money is temporary and paid upfront. Details come in Q1 2027, and practices apply for it in the same application as the pilot
The dates:
Early 2027: final details and preliminary payment rates
Spring 2027: provider applications
Late spring 2027: selection, capacity-building awards, binding letters of commitment
January 1, 2028: launch
The feedback and interest form closed yesterday. The readiness assessment is required and NC AHEC’s help with it is free, which is worth knowing if you sell practice-transformation services in North Carolina.
North Dakota moves Childcare for the Rural Health Workforce and Non-Emergency Medical Transportation Acquisition to Awarded
Both flipped from Closed to Awarded overnight:
Childcare for the Rural Health Workforce – Awarded | 8 Applicants (it read 9 while Closed)
Non-Emergency Medical Transportation Acquisition – Awarded | 13 Applicants
No recipients and no dollar amounts on the page. In October we noted the $3 million childcare opportunity drew 9 applicants against 38 planned awards, and we covered Non-Emergency Medical Transportation Acquisition when it opened. As far as I can tell, North Dakota’s named subawards have reached USAspending before they’ve reached any state page, so that’s where the recipients are likely to show up first.
