Below you will see an announcement from DHS regarding the Rural Health Transformation Program that was included in H.R. 1 (otherwise known as the Big Beautiful Bill).

CMS has prioritized the following areas. I also had a conversation with a group at MDH who will be working on this project. They shared that sustainability and workforce are particularly important.

  *   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.

Paulette and I met with a group of providers who serve rural communities (thank you, Kristy and Katie) and identified 3 top priorities based on what we've learned and the feasibility.

There is a very short timeline and I need to submit this by Friday so there isn't time to discuss it at our board meeting. I feel good about the input from this small group but also welcome input from the board. Attached is a VERY ROUGH draft, which I will fine-tune and upload to the online form.

Please get any comments back to me by Weds or Thursday am, at the latest. I know it's a quick turnaround so if you don't have time to review this, I understand.

Kind Regards,

Kathy Messerli
Executive Director
Minnesota Home Care Association

2909 S. Wayzata Blvd. | Minneapolis, MN 55405
Direct: 651.635.0038 | Main: 651.635.0607
www.mnhomecare.org<http://www.mnhomecare.org/page/A17> | kmesserli@mnhomecare.org<mailto:kmesserli@mnhomecare.org>

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[ORHPC]

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September 9, 2025

Rural Health Transformation Program

The Federal Reconciliation Bill (HR1)<https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.congress.gov%2Fbill%2F119th-congress%2Fhouse-bill%2F1/1/01010199312b350a-ee1c2fad-c4b6-4a82-afe6-3c06c12ed3e6-000000/U5LT8RHgcUHY0yuq3qhaH_3ThDfwrOOJonIQO7HOh88=422> amended section 2105 of the Social Security Act and was signed into law on 7/4/2025. The bill made major changes to public assistance programs such as Medicaid, which will lead to loss of benefits or coverage for Minnesotans who rely on that program.

To help address health care access and delivery in rural areas, the legislation allocated $50 billion dollars over five fiscal years for a new Rural Health Transformation Program<https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.cms.gov%2Fpriorities%2Frural-health-transformation-rht-program%2Frural-health-transformation-rht-program/1/01010199312b350a-ee1c2fad-c4b6-4a82-afe6-3c06c12ed3e6-000000/iEn4HMtdpGC9-5GYtsBd1sZsTAYW6xD0ZnBDxvLeboA=422> as a one-time effort to fund rural health priorities over the next five years.

The bill language specifies that:

  *   Half (50%) of funds will be distributed equally to each state with an approved application over 5 federal fiscal years. This is equivalent to $25 billion distributed annually between Federal Fiscal Year 2026-2030.

  *   The remaining 50% of funds ($25 billion) will be distributed among at least one-fourth of the states with approved applications, at the discretion of the Centers for Medicare and Medicaid Services (CMS) Administrator.

In compliance with Congressional language, Minnesota will be submitting one application to CMS for the entire 5-year period. This application must outline our state's proposed Rural Health Transformation Plan.

________________________________
Please share your input

Minnesota is seeking input on ideas that will transform rural health and strengthen rural health care delivery, especially for emergency services, primary care, care for people with complex and chronic conditions, mental and behavioral health care, maternal health care, and other at-risk services. Please use the Rural Health Transformation Plan - Public Comments<https://links-2.govdelivery.com/CL0/https:%2F%2Fmnhealth.qualtrics.com%2Fjfe%2Fform%2FSV_3Xd6Rz8gfNyG502/1/01010199312b350a-ee1c2fad-c4b6-4a82-afe6-3c06c12ed3e6-000000/8SaJDPlbaqexEg1Cm__sNudnh1WoyLqrs6i2ZC2M_rA=422> to share your thoughts and ideas for developing our Rural Health Transformation Program application.

Who should respond to this request?

Input from all voices and perspectives is welcomed to understand rural needs and opportunities. This includes:

  *   Health care providers in all settings
  *   Administrators or workers in all types of hospitals (small independent, critical access, etc.)
  *   Community groups and/or advocacy organizations
  *   Public health workers
  *   Patients
  *   Researchers
  *   The general public

When are responses due?

Please provide input by September 26.

Find detailed information on Minnesota's Rural Health Transformation Program and ongoing updates at health.state.mn.us/facilities/ruralhealth/ruraltrans.html<https://links-2.govdelivery.com/CL0/https:%2F%2Fwww.health.state.mn.us%2Ffacilities%2Fruralhealth%2Fruraltrans.html/1/01010199312b350a-ee1c2fad-c4b6-4a82-afe6-3c06c12ed3e6-000000/PgxmRqwdsGhP0PQTA_KuoMe9gp9gDHZezZ6FwGYwW4o=422>.

Please email rural.transformation.mdh@state.mn.us<mailto:rural.transformation.mdh@state.mn.us> with questions.

The Office of Rural Health and Primary Care (ORHPC) promotes access to quality health care for all Minnesotans. We work as partners with policymakers, providers, and rural and underserved urban communities to ensure a continuum of core health services throughout the state.

651-201-3838

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