Rural Health Transformation Program (RHTP)

For determining rural and non‑rural counties, MDHHS uses the Federal Office of Rural Health Policy (FORHP) county and census tract classifications. This includes all counties identified by FORHP as fully rural, as well as those designated as partially rural, regardless of the number of rural census tracts, which are county subdivisions outside densely populated urban areas. Consistent with the RHTP description outlined in the project narrative, funding decisions will follow a needs‑based prioritization framework that focuses on counties experiencing high rates of chronic disease, limited access to hospitals and primary care, including OB/GYN and behavioral health, high Medicaid dependence, socioeconomic vulnerability and elevated levels of child poverty or aging populations.

MDHHS will further prioritize funding based on the percentage of the population living in U.S. Census‑defined rural areas. This approach recognizes that rural residents in more populous counties may face additional access challenges due to geographic dispersion and service capacity limitations, which refer to the maximum threshold an operation can handle without compromising quality. Using this method, funding will be directed first to high‑need rural areas with larger rural populations. Partially rural counties will be prioritized according to the share of residents living in rural census tracts, ensuring resources are allocated where they can have the greatest impact.

This table shows the percentage of rural population, based on the 2020 census, within partially rural counties in Michigan.

The RHT Program seeks to further the following Strategic Goals:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

During the pre-implementation planning period (November-December 2025), a Cross-Departmental Coordination Team will be established to:

• Offer expert input based on each division’s area of specialization to inform program design and sustainability planning.
  Provide cross-departmental guidance to maximize impact, identify opportunities for shared investments, and prevent duplication of funding or programmatic efforts.
• Provide guidance on language to include in Grant Funding Opportunity (GFO) and may participate on Joint Evaluation Committee to review and select grantees.
• Review progress reports, performance data, and partner feedback to identify challenges and recommend course corrections to leadership.
• Act as liaisons between their divisions and the RHT Program Office to support coordinated messaging, consistent reporting, and timely decision-making.

An RHT Advisory Council will be established to:

• Support the development and implementation of an engagement strategy to strengthen collaboration with rural health partners, community leaders, and residents throughout the program lifecycle.
• Provide insight and feedback to improve partner participation during implementation and evaluation, ensuring that community and stakeholder perspectives inform ongoing refinement of initiatives.
• Offer actionable recommendations to MDHHS to inform strategic direction and policy decisions across the Rural Health Transformation initiatives.
• Serve as a bridge between state leadership, local stakeholders, and rural communities to ensure transparent communication and shared understanding of program priorities and outcomes.

To stay updated on the process of seating the RHT Advisory Council, including when the nomination period will open, please sign up for email updates via the RHT listserv.

A GFO will soon be released to support RHT efforts. Details about eligibility, timelines, and application requirements will be shared once the GFO is published.

To receive updates as soon as the RHT GFO is released, please sign up for the listserv. Subscribers will be the first to know when the funding announcement, application materials, and technical assistance resources become available.