As noted above, $50 billion will be available over five years, meaning $10 billion annually. Fifty percent of the funds will be distributed equally among the states with successful applications. The other 50% will be allocated by CMS based on a variety of factors such as rural population, the fiscal situation of certain hospitals in the state, and other additional elements.
USE OF FUNDS
Strategic goals for the program include:
- Make rural America healthy again: Support rural health innovations and new access points to promote preventative health and address root causes of diseases. Projects will use evidence-based, outcomes-driven interventions to improve disease prevention, chronic disease management, behavioral health, and prenatal care.
- Sustainable access: Help rural providers become long-term access points for care by improving efficiency and sustainability. With RHT Program support, rural facilities work together—or with high-quality regional systems—to share or coordinate operations, technology, primary and specialty care, and emergency services.
- Workforce development: Attract and retain a high-skilled health care workforce by strengthening recruitment and retention of healthcare providers in rural communities. Help rural providers practice at the top of their license and develop a broader set of providers to serve a rural community’s needs, such as community health workers, pharmacists, and individuals trained to help patients navigate the healthcare system.
- Innovative care: Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements. Develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs) to reduce health care costs, improve quality of care, and shift care to lower cost settings.
- Tech innovation: Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, strengthen cybersecurity, and invest in emerging technologies.
According to the CMS webpage, the RHT program funds must be used for three or more of the following interest areas:
- Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
- Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator.
- Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
- Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
- Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
- Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
- Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
- Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services.
- Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
- Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator.
Technology and technology-enabled solutions are mentioned several times in the list above, signaling an opportunity to utilize these funds for telehealth-related projects/solutions. Additionally, while other items on the list may not mention technology directly, proposals could still employ telehealth in addressing the issue, such as promoting sustainable access to health care services. For example, “supporting access to opioid use disorder treatment services and other substance use disorder treatment services, and mental health services,” which are areas where telehealth has been widely and effectively used, in addition to addressing workforce shortages and chronic disease prevention.
HOW TO GET INVOLVED
As noted previously, each application must come from the state, and as highlighted in this helpful RHTF Overview prepared by Manatt Health, Governors may designate a state entity to complete and submit the application. Only one application for funding is required for the five-year period, although annual reports regarding funding allocations will additionally be required upon approval. A letter of support from the Governor must also be submitted along with the application. If telehealth community members are interested in suggesting or being involved in the development of a state’s application, they must work with the appropriate agency spearheading the application for that state. The department or agency in charge of those efforts may vary from state-to-state. For example, one state may have their State Office of Rural Health take the lead, while another might have selected their Health and Human Services agency to head-up the application process. Interested parties should start inquiring as to who will be leading efforts within their state if they wish to be involved in their stakeholder process. Princeton University’s State Health & Value Strategies has been tracking the efforts states have been making on their “Tracking State Preparation for the Rural Health Transformation Program” page, showcasing that many are currently requesting public input.
Now is the time to be engaged with the state and their efforts in applying for this funding, or if they do not intend to, perhaps to convince them of the merits in responding to the NOFO. Many states have established their own RHT program websites, such as California’s Department of Health Care Access and Information (HCAI) State Office of Rural Health (CalSORH). For complete application instructions and requirements, read the full RHT Program NOFO. |
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