Gov. Gianforte, DPHHS Submit Rural Health Transformation Plan

Governor's Office

HELENA, Mont. - Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Charlie Brereton today announced that Montana has officially submitted its application for the federal Rural Health Transformation Program (RHTP), a critical initiative that could secure over $1 billion in federal funding to modernize health care in rural areas of the state over the next five years.

"The Rural Health Transformation Program is a historic investment in Montana's future," Gov. Gianforte said. "Since taking office, we've led on fixing what's broken, making investments to improve access to quality health care. With the Rural Health Transformation Program, we will continue delivering better outcomes for families across Montana."

The RHTP, established by the U.S. Centers for Medicare and Medicaid Services (CMS), is authorized to provide up to $50 billion nationally to participating states through 2030. This funding is specifically earmarked for stabilizing, transforming, and restructuring rural hospitals and other essential health care providers.

"We are appreciative of the hundreds of Montanans and organizations who engaged in this process over the past several weeks," DPHHS Director Charlie Brereton said. "Their participation was essential in shaping a quality application rooted in sustainability and the needs of our communities, and we are extremely proud to submit it today."

Montana submitted its Rural Health Transformation Plan ("Plan") in advance of the Nov. 5, 2025, deadline. States were given approximately six weeks to develop their plans.

During the plan development process, DPHHS closely scrutinized proposals for sustainability and prioritized transformative initiatives that don't require ongoing RHTP funding to remain in effect. With award decisions expected in late December, DPHHS will now shift to implementation planning, including establishing and hiring for an internal RHTP unit responsible for administering the program over a five-year period.

Montana's plan outlines five core initiatives, all designed to address the unique challenges of rural health care delivery in a sustainable manner:

• Workforce Development: Focuses on increasing recruitment, expanding clinical training, and retaining various levels of rural health care providers in strong partnership with the Montana Department of Labor and Industry.

• Sustainable Access: Stabilizes rural facility finances through restructuring recommendations and increased clinical and administrative partnerships. This component includes funding for the expansion of telehealth services, linking rural hospitals with statewide specialists and providing one-time-only awards for necessary telehealth equipment.

• Innovative Care Models: Strengthens and expands value-based payment models and better leverages EMS and pharmacy services, with an emphasis on reducing emergency room admissions and other high-cost care interventions.

• Community Health and Prevention: Provides for infrastructure upgrades and initiatives that incentivize healthy lifestyles, including expanding primary, behavioral, and dental health services in schools through partnerships with Federally Qualified Health Centers and other providers.

• Technology Innovation: Focuses on using technology to increase access and improve data quality and sharing. This component includes funding for rural providers to modernize their Electronic Health Record systems.

DPHHS incorporated vital rural health metrics, including those pertaining to glycemic status, hypertension, obesity, and suicide rates, into its long-term commitment to evaluating and monitoring Plan outcomes.

The plan was developed using public input collected over several weeks, including a Request for Information (RFI), a statewide webinar with nearly 900 registrants, a formal tribal consultation, direct engagement with over 20 external stakeholder groups, all eight tribal nations and Urban Indian Organizations, and close collaboration with several other state agencies.

RHTP funding will be allocated to states based on a formula: 50% divided equally among all approved states, 25% based on states' rurality, and 25% based on how well each state's proposed plan aligns with CMS criteria.

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