What is the Mississippi Rural Health Transformation Program?
- The Rural Health Transformation (RHT) Program was authorized by the One Big Beautiful Bill Act (Section 71401 of Public Law 119-21) and empowers states to strengthen rural communities across America by improving health care access, quality, and outcomes by transforming the healthcare delivery ecosystem.
- Through innovative system-wide change, the RHT Program invests in the rural health care delivery ecosystem for future generations. RHT Program funding is $50 billion to be allocated to approved states over five fiscal years, with $10 billion available each fiscal year, beginning in fiscal year 2026 and ending in fiscal year 2030.
- The funding opportunity was coordinated through each state’s governor’s office, with states responsible for administering the funds in ways that best meet their local needs. In Mississippi, the program has been shaped through collaboration with multiple state agencies and external partners, and this collaborative approach will continue throughout the life of the program.
- Mississippi’s RHT Program offers an opportunity to transform how health care is delivered in rural areas. It supports easier access to care, stronger community partnerships, more local health workers and modern technology that helps providers connect and coordinate.
More Questions & Answers
How did Mississippi design the program?
To develop our application, the Mississippi Governor’s office solicited public input and received 145 responses, with stakeholders coming from nearly half of the counties in the State. Respondents included state health officials, public health workers, healthcare providers and administrators, health plan representatives, members of the public, legislators, and potential vendor partners. This input from stakeholders directly influenced the State’s plan. The Governor’s office also collaborated with the MS State Department of Health, Department of Medicaid, and Department of Mental Health to develop our plan and application.
We also reviewed national best practices and innovative models from across the country, along with Mississippi-specific data, to guide initiatives focused on the areas of greatest risk.
While no single plan can address every challenge, the RHT Program creates an opportunity to better understand health needs in rural Mississippi and invest in meaningful, locally driven solutions. It lays the foundation for lasting change, but continued collaboration will be essential.
We encourage communities and stakeholders to engage in ongoing dialogue and collaboration, working together toward addressing the complex realities of rural health care.
When will funding opportunities be available?
Timely distribution of funding, in accordance with 2 CFR Part 200, is our top priority. As program details are finalized, funding opportunities and updates will be posted.
When and how will entities be able to apply for funds?
We will post information about how to apply for funding on the Mississippi RHTP webpage as it becomes available.
Does Mississippi have to prove outcomes to CMS?
- Yes, reporting is a requirement.
- The annual reporting is consistent with other CMS grant opportunities and is structured to ensure states use funding consistent with the terms of the cooperative agreement. CMS uses these reports to track progress on state initiatives, evaluate compliance with cooperative agreement terms, and inform decisions on future funding amounts.
- For the RHT Program, states will also report quarterly and annually on progress on their work plans, timelines, milestones, and achievement of measurable outcomes.
- The specific outcomes and milestones that Mississippi will be required to report to CMS will be determined by the final terms of the awarded cooperative agreement.
Will this improve access to care?
The state has prioritized improving access to health care. Specific programs aimed at expanding access include transportation support, investments in workforce, and the expansion of technology.
When is the first budget period?
The first budget period is through October 30, 2026. All first-year funds must be obligated by this date and spent by the end of federal Fiscal Year 2027, which ends on September 30, 2027.
How does the state plan to keep Mississippians updated on the RTHP?
Mississippi will place progress updates on the Mississippi RHTP webpage.
Did Mississippi receive funding for everything in the application?
Mississippi’s Rural Health Transformation Plan and detailed budget submission for the current funding year have been fully reviewed and approved by CMS. Funding opportunities in the current funding year will align with the approved Plan and detailed budget.
Were there any exclusions/limitations to what the funding can cover?
- Yes, there were several funding limitations set by CMS, including new construction, provider payments to replace payment for clinical services reimbursable by insurance, pre-award costs, and more.
- More information on funding restrictions can be found on the CMS FAQ webpage.
Will there be a scoring rubric or framework used to direct RHT Program funding to rural providers and patients in Mississippi?
Yes. Each RHT Program funding opportunity will include its own project-specific scoring rubric and evaluation criteria designed to align with the goals and priorities outlined in Mississippi’s approved RHT Plan. Funding decisions will be made based on how well proposed projects support the intended outcomes of the program and address the healthcare needs of rural Mississippians. Additional information about Mississippi’s RHT Plan is available on this website.
Will Mississippi release additional budget information related to the RHT Program, including funding amounts associated with specific objectives or initiatives?
As program funds are awarded, Mississippi will release additional information relating to its approved amended budget. The approved amended budget contains highly sensitive technical and detailed budgeting information that could jeopardize and undermine the competitive nature of the applicable procurement process. Specifically, if potential subgrantees are able to gain access to detailed budgeting information for each initiative in advance of procurement, they might use such information to inflate their bids and thereby deplete the limited federal funds that are critical to improving health outcomes in rural Mississippi. Protecting such detailed budgeting information from public discloser prior to the conclusion of each procurement is necessary for the State to be good stewards of the grant funds and is consisted with Mississippi law.
What transparency measures with the State implement regarding the awarding and use of RHT Program funds?
As a condition of the RHT Program cooperative agreement award, the State must comply with all applicable federal grant administration, procurement, monitoring, reporting, and audit requirements, including those set forth in 2 CFR Part 200 and 2 CFR Part 300, as incorporated in the RHT Program Notice of Funding Opportunity (NOFO). Such federal requirements incorporate and are consistent with the procurement, auditing and transparency requirements under Mississippi law, including the Mississippi Public Records Act. The State will fully comply with all such requirements and remains committed to transparency, accountability, and public engagement throughout implementation of the program. Information regarding program activities, funding opportunities, procurements, and implementation progress will continue to be shared through appropriate public channels, including the MS RHTP website (mississippirhtp.com).
Will awarded contracts be made public in close proximity to the award decision?
Yes. Consistent with applicable federal and state transparency requirements, information regarding awarded contracts will be made publicly available following completion of the procurement and award process and in accordance with 2 CFR 200 requirements, Mississippi procurement laws, and any other applicable legal or contractual considerations. Procurement information and related updates may also be shared through the MS RHTP website (mississippirhtp.com ) as appropriate.
How does the State ensure fairness and equal access during the development and release of NOFOs and RFPs?
The State is committed to conducting all procurements and funding opportunities in a fair, competitive, ethical, and legally compliant manner. NOFOs, RFPs, and related procurement materials are not shared with stakeholders in advance of public posting in a manner that would provide an unfair competitive advantage or conflict with applicable procurement requirements, ethical obligations, or federal and state law.
When will grant opportunities for hospitals become available under the RHT Program?
The first round of funding opportunities open to hospitals is expected to be released on June15. Additional information, including eligibility requirements and application materials, will be posted under the Funding Opportunities tab on the MS RHTP website (mississippirhtp.com) as such information becomes available.
Can you provide general information about the status of funding awards and commitments under the RHT Program?
At this time, no programmatic funds have been awarded or promised to specific stakeholders outside of the procurement process, other than the third-party administrative support contract. Future funding opportunities and awards will be administered in accordance with applicable federal and state procurement, grant, and program requirements, including 2 CFR 200.
Can you provide additional detail regarding the competitive procurement, application, and evaluation processes that will be used for RHT Program contracts and funding opportunities?
All procurements, funding opportunities, and application processes conducted under the RHT Program will be administered in accordance with all applicable federal and state laws, including procurement requirements, CMS requirements, and Uniform Guidance requirements under 2 CFR 200. Evaluation and award processes will be designed to promote fairness, transparency, competition, accountability, and alignment with the goals of Mississippi’s approved RHT Plan.
Will grant recipients be required to incur costs and seek reimbursement, or will funds be provided in advance?
In general, the standard approach for RHT Program grants and funding opportunities will be reimbursement-based, meaning recipients will be expected to incur allowable costs and then seek reimbursement in accordance with applicable requirements. However, the State recognizes that some providers, particularly for larger expenditures or capital-intensive projects, may not be in a position to advance significant project costs. In those circumstances, alternative funding arrangements may be considered by the state on a case-by-case basis in accordance with applicable CMS guidance, 2 CFR 200 requirements, and state financial and grant management policies.
Contact Us
Looking for more information on the Mississippi Rural Health Transformation program? Reach out to our program managers by submitting the form below.