The State of Missouri has submitted its Rural Health Transformation (RHT) plan to the Centers for Medicare & Medicaid Services (CMS), outlining a possible strategy to improve healthcare access, quality, and long-term sustainability in rural communities.
The plan represents Missouri’s effort to participate in the national Rural Health Transformation Program, a new federal initiative designed to strengthen healthcare systems in rural areas through innovation, collaboration, and investment.
Authorized under the One Big Beautiful Bill Act, the RHT Program empowers states to reimagine healthcare delivery through system-wide transformation. Its focus is on enhancing access to care, developing a sustainable healthcare workforce, expanding the use of technology, and improving patient outcomes across rural America.
Under the federal initiative, CMS will distribute $50 billion in funding over five years, beginning in fiscal year 2026 and continuing through 2030. Half of that amount will be distributed equally among approved states, while the other half will be allocated based on factors such as each state’s rural population, the number and condition of rural health facilities, and other criteria to be outlined in a forthcoming Notice of Funding Opportunity.
Missouri’s plan was developed in collaboration with the Governor’s Office, the Department of Social Services (DSS), the Department of Health and Senior Services (DHSS), and the Department of Mental Health (DMH). The effort also included input from healthcare providers, hospitals, and local partners across the state.
The Missouri RHT proposal focuses on several key goals:
- Expanding access to primary care, behavioral health, and maternity services in rural areas.
- Building regional care networks that connect hospitals, clinics, pharmacies, and public health agencies to better coordinate patient care.
- Enhancing provider sustainability through shared savings incentives, improved operations, and investment in advanced technology.
- Expanding telehealth and digital health tools to bring specialized care closer to home for rural residents.
“The Department of Social Services was proud to collaborate across state agencies and with key stakeholders to craft this bold plan,” said DSS Director Jess Bax. “We look forward to continuing our work to support Missourians with this historic funding opportunity that will change the landscape of healthcare access and outcomes for rural Missourians.”
At the national level, the RHT Program sets out several strategic goals to guide state efforts. These include improving disease prevention and chronic disease management, promoting sustainable and efficient rural healthcare systems, supporting innovative models of care, and strengthening the healthcare workforce through targeted recruitment and retention initiatives. The program also emphasizes the use of technology to improve care delivery, enhance cybersecurity, and expand access to digital health tools.
States may use their RHT funds for a variety of approved purposes, including workforce training, telehealth expansion, investment in technology infrastructure, chronic disease prevention programs, and the development of new care models focused on long-term outcomes and cost efficiency.
CMS is expected to review state proposals over the coming year, with funding awards anticipated by December 31, 2025. Once approved, states will receive their allocations through cooperative agreements distributed over a five-year period beginning in 2026.
