December 16, 2025

The President’s Message is published in the MHA Weekly News Report, a member only publication of the Montana Hospital Association. To subscribe, click here.

The Montana Department of Health and Human Services (DPHHS) this week presented an update on the Rural Health Transformation Program (RHTP) to the Interim Budget Committee for Section B. We were watching closely to see if any further detail on the program budget was released, as it indicates focus and opportunity areas for the membership. I’ll summarize the highlights here.

As a reminder, the Centers for Medicare and Medicaid Services (CMS) asked each state to develop a $1 billion budget of $200 million per year for five years. One billion dollars would be exactly 1/50th, or an equal share, of the total program funding. The final funding distribution to Montana will be announced by CMS later this month, and DPHHS believes it will be in the range of $900 million to $1.3 billion in total. We believe that, given the high rurality of our state and DPHHS’s multi-initiative application, Montana will receive more than its equal share.

Montana’s RHTP application is structured around five integrated initiatives aligned with Montana’s rural health priorities: (1) workforce recruitment, training, and retention: $118 million (11.8%); (2) sustainability and access for rural health facilities through partnerships and restructuring: $474 million (47.4%); (3) innovative care delivery and payment models: $120 million (12%); (4) investments in community health and prevention: $150 million (15%); and (5) deployment of modern health technologies to improve access and outcomes: $108 million (10.8%). The state proposed holding $30 million (3%) for program administration costs.

Hospitals will play the largest role and have the greatest access to funds under Initiatives 2, 3 and 5. The plan proposes distributing to hospitals at least 93%, 65% and 60% of funds in each bucket, respectively.

Workforce development is a central focus of Montana’s plan, and 100% of the proposed funding allocation ($118 million) in Initiative 1 would be directed to the Montana Department of Labor and Industry. Hospitals and healthcare providers are expected to still play a large role. Strategies include early exposure programs that connect high school students to health careers through pre-apprenticeships and expanded Career Technical Student Associations. These efforts are expected to reach more than 1,500 rural students, supported by approximately $17 million over five years. School-based health initiatives are also included in the state application, emphasizing access to primary and dental care and healthy lifestyle programs. Up to $44 million is budgeted over five years to improve metrics such as well-child visits and youth mental health outcomes.

You’ll find a link to the presentation here, as well as on the RHTP section of the MHA website at www.mtha.org/RHTP. Please visit and share this site for RHTP information, including an overview of the RHTP, MHA’s activities to advocate for the field and secure funds for hospitals, projected timelines, and the anticipated process by which individual facilities and groups can apply for and receive funds.