Connecticut Submits Rural Health Transformation Program Application

On Tuesday, November 4, the Connecticut Department of Social Services (DSS) submitted the state’s application for the Centers for Medicare and Medicaid Services’ (CMS) Rural Health Transformation (RHT) Program.  State officials anticipate that Connecticut, upon federal approval of the application, will receive at least $100 million per year for five years starting in 2026.  Connecticut’s RHT Plan centers on four interdependent initiatives, as summarized below.

1. Population Health Outcomes: Advance prevention, chronic care, maternal and behavioral health integration, and address root causes of disease
2. Workforce: Strengthen recruitment, training, and retention of physicians and other healthcare practitioners and staff through education partnerships, telehealth support, and career pipelines
3. Data and Technology: Expand interoperability, health information exchange participation and capacity, telehealth infrastructure, and analytics to guide performance and policy, and improve healthcare providers’ ability to coordinate care and improve population health
4. Care Transformation and Stability: Promote enhanced capacity at rural healthcare providers to improve quality and population health, including by supporting the adoption of value-based models, integrated care teams, and sustainable funding mechanisms for rural healthcare providers

According to a required endorsement letter from Governor Ned Lamont, during the RHT implementation period, DSS will convene a new Rural Health Transformation Advisory Council that will continue to engage with stakeholders to review progress, address implementation challenges, and ensure continued alignment with CMS priorities. Additionally, the DSS commissioner will establish a new Division of Rural Health Transformation to provide overall management and oversight of the grant, in conjunction with the Office of Policy and Management (OPM).  DSS will also serve as the state’s primary contact with CMS and will continue to collaborate with other state agencies to implement the RHT Plan, especially OPM and the Connecticut Office of Rural Health (ORH), to ensure alignment with statewide reform priorities.

Notably, the governor wrote, “to help expedite various proposals in our RHT Plan that impact hospitals, I will submit state legislation to substantially reform our certificate of need requirements, which will simplify our outdated regulatory system and promote a more competitive market,” and said the administration will continue to champion the state’s participation in interstate licensure compacts, such as the Nurse Licensure Compact that Connecticut officially joined last month.

In response to DSS’s solicitation for public input on the state’s grant application, the Connecticut Hospital Association (CHA) submitted a comment letter in October urging state officials to develop a two-pronged approach that invests directly in rural hospitals as well as the broader network of clinical services that extend care to rural patients.

Grant Application Requirements

The RHT Program was established under Section 71401 of Public Law 119-21, or H.R. 1.  All 50 states submitted a one-time grant application to CMS.  As part of their RHT Program grant application, states were required to propose an RHT Plan addressing the following topics:

• Improve access to hospitals, other healthcare providers, and healthcare items and services furnished to rural residents of the state
• Improve healthcare outcomes of rural residents of the state
• Prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management
• Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other healthcare providers to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery
• Enhance economic opportunity for, and the supply of, healthcare clinicians through enhanced recruitment and training
• Prioritize data and technology-driven solutions that help rural hospitals and other rural healthcare providers furnish high-quality healthcare services as close to a patient’s home as possible
• Outline strategies to manage long-term financial solvency and operating models of rural hospitals in the state
• Identify specific causes driving the accelerating rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction

CMS will announce all funding decisions for states by December 31.