August 14, 2026

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.

Members of the MHA’s leadership team participated last week in the second meeting of Montana’s Rural Health Transformation Program (RHTP) Stakeholder Advisory Committee.

The meeting was hosted in Bozeman by the Montana Office of Rural Health on behalf of Montana’s Department of Public Health and Human Services (DPHHS). It provided an important update on implementation and what members can expect as Montana prepares to move from building the program’s foundation to putting funding to work.

For many, Year 1 of RHTP has felt like a slow start. That is understandable. While Montana received a significant first-year award, much of the State’s work focused on building the framework required to responsibly administer the program.

Year 1 work by DPHHS includes hiring staff (almost 85% of planned staff have been hired), developing contracts and grant processes, establishing reporting and compliance structures, and putting partnerships in place to support implementation.

That groundwork is beginning to pay off. DPHHS reported that approximately $157 million in Year 1 funding has been operationalized, with the remaining $76 million planned and on track for obligation by the end of the fiscal year. While some funding opportunities have been released or awarded, we expect members will begin to see funding flow more significantly in Year 2 and throughout Years 3–5 as the infrastructure developed this year is put into action.

An important piece of that infrastructure is the development of RHTP Initiative 2 (Sustainable Access) Center of Excellence (CoE). The MHA has been selected to lead the implementation work for Initiative 2. The State has published the Notice of Intent to Award (NOIA) selecting Indelible as the CoE Strategy & Analytics partner. Together, these efforts will help ensure decisions are informed by data, and that providers have hands-on support to turn RHTP investments into sustainable operational improvements. The State has also established a 25-member CoE Advisory Council focused on data-backed recommendations for rural facility financial sustainability.

Several important milestones are immediately ahead. Montana’s Year 1 Annual Report and Year 2 application are due to CMS on Aug. 31, followed by the Oct. 30, deadline to obligate Year 1 funding. DPHHS also expects the Year 2 award to be announced around that time. These deadlines are especially important because future funding will depend, in part, on the quality and pace of Montana’s implementation.

RHTP is a five-year transformation effort, and Year 1 has largely been about program building. As we enter Year 2, we expect the pace—and the flow of resources to Montana providers—to increase. MHA will continue to work alongside and support members to ensure those resources are used responsibly, strategically, and in ways that strengthen rural healthcare long after RHTP funding ends.