For rural practices, funding a connected-care program involves more than purchasing devices or software. Someone needs to help patients get started, follow up between visits, and keep the operation running after the initial investment. Rural Health Transformation Program funding can support certain RPM and care-coordination initiatives, but eligibility depends on the state’s approved approach, the specific funding opportunity, and the proposed use of funds. The program’s approved uses include chronic disease management, technology-enabled care, and remote monitoring, but those priorities do not automatically make a practice or vendor eligible for payment.
Remote patient monitoring (RPM) involves collecting and reviewing health data transmitted by connected devices, such as blood pressure readings. Care coordination includes follow-up, referral support, and communication among patients and their care teams. The two can work together when information from monitoring leads to outreach, clinical review, or another care action.
At 1bios, our approach starts with a practical idea: You already have the patients. We bring the operation. For a practice exploring RHTP funding, that means considering the team and workflows needed to deliver care alongside the initial technology investment. Funding fit and operating fit are separate questions, and both need clear answers before a program launches.
At a glance: Can RHTP funding support RPM and care coordination?
Yes, certain RPM and care-coordination initiatives may qualify for Rural Health Transformation Program funding. Eligibility depends on the state's approved initiative, the specific funding opportunity, and the proposed expenses. Alignment with RHTP goals does not automatically qualify a practice, vendor, or service for payment.
- Start with your state. States receive the direct federal awards. Practices should identify the relevant state opportunity and confirm how they can participate.
- Verify each expense. Ask the administrator to review devices, software, implementation, training, staffing, and contracted services under the opportunity's requirements.
- Separate funding from reimbursement. RHTP funds cannot replace or modify payment for clinical services that could be reimbursed through insurance or other health coverage.
- Assign the daily work. Define who handles enrollment, device setup, missing readings, patient outreach, clinical handoffs, and documentation.
- Plan beyond the award. Identify who will perform ongoing work, what it will cost, and which verified funding sources will support it after temporary funding ends.
Review the program's approved uses and eligibility requirements alongside CMS guidance on funding restrictions and sustainability before developing your project budget.
What is the Rural Health Transformation Program?
The Rural Health Transformation Program, often called RHTP or the RHT Program, provides $50 billion in federal funding allocated over fiscal years 2026 through 2030. States are the direct federal award recipients, rather than individual physician practices. For a practice, the starting point is its state’s program and the opportunities available through that program.
A state’s broad transformation plan is useful context, but it is not the same as an application invitation or an approved project budget. Before committing resources, find the relevant state notice and identify the organization administering it. Ask whether your practice would participate as an applicant, a project partner, a contractor, or a provider serving patients through another organization’s initiative.
When can RHTP funding support RPM or care coordination?
RPM and care coordination can fit an RHTP initiative when they address an approved rural-care need and the proposed expenses meet the funding requirements. A useful proposal connects the service to a specific access or care-delivery problem. It explains who will receive support, what will change, and how the work will be carried out.
There are concrete state examples of this connection. South Carolina’s Connections to Care initiative identifies remote patient monitoring, telehealth, electronic health records, and a statewide resource database as tools for improving coordination and access. That demonstrates a state-level path for this work, but it does not establish eligibility for a different state or mean that an application window remains open.
Care coordination also needs a more precise description than its name alone provides. A project might involve following up after visits, helping patients navigate referrals, addressing barriers to participation, or connecting monitoring findings with the treating clinician. Describe those activities individually so the funding administrator can evaluate the proposed scope and costs.
What should a rural practice verify before building a proposal?
Start with the actual funding opportunity and its current instructions. A vendor’s statement that its services align with RHTP goals is not an award determination. Obtain answers from the administering organization and keep them with the project’s planning records.
- Applicant eligibility: Can your organization apply directly, or must it participate through another entity?
- Geographic eligibility: Which communities, service areas, or patient populations does the opportunity cover?
- Project fit: Which approved initiative and objectives would your proposed program support?
- Allowable expenses: How are devices, software, implementation, training, personnel, and contracted services treated?
- Timing: When may spending begin, and what are the obligation, expenditure, and reporting deadlines?
- Purchasing requirements: What procurement, vendor-selection, subcontracting, or approval procedures apply?
- Payment arrangements: Are approved expenses reimbursed after payment, funded in advance, or handled through another mechanism?
- Reporting and continuation: What records, milestones, measures, and conditions will your organization need to meet?
Ask about individual expenses rather than whether an entire “RPM package” qualifies. A bundled price may combine technology, implementation, clinical services, and administrative work that require different treatment. Have the proposed scope broken into understandable components before asking the administrator to review it.
RHTP funding: What should your practice verify?
| Proposed expense | Questions for the funding administrator | Details to prepare for review |
|---|---|---|
| Devices | Are the proposed devices allowable for this initiative and patient population? What purchasing, ownership, replacement, and end-of-project requirements apply? | Device types, quantities, intended users, itemized costs, and distribution plan. |
| Software and connectivity | Are platform licenses, interfaces, and device connectivity charges allowable? Which service periods may be funded, and what restrictions apply to recurring charges? | Itemized fees, contract dates, technical requirements, and post-award costs. |
| Implementation | Which setup, workflow-design, and data-transfer activities are allowable? When may work begin, and is advance approval required? | Scope of work, deliverables, timeline, responsible parties, and one-time costs. |
| Training | Which staff or patient-training activities qualify? How should training time, materials, and shared personnel costs be documented and allocated? | Training plan, intended participants, learning objectives, and cost breakdown. |
| Clinical services | How do restrictions on replacing insurance-reimbursable services apply? Are any proposed activities allowable, and how must they be separated from billable care? | Defined activities, payer review, existing funding sources, and a plan to prevent duplicate funding. |
| Care coordination | Which specific coordination activities fit the initiative? How should the project distinguish new work from existing funded activities or reimbursable services? | Patient population, task descriptions, staffing assignments, and cost-allocation approach. |
| Contracted support | Are the proposed contracted functions allowable? What vendor-selection, procurement, subcontracting, and approval requirements apply? | Itemized proposal, partner responsibilities, deliverables, pricing, and contract terms. |
| Reporting and evaluation | Which reporting and evaluation expenses are allowable? How are they classified, and what limits, measures, and recordkeeping requirements apply? | Reporting plan, data sources, responsible staff, estimated effort, and budget. |
Every category requires review under the specific funding opportunity. Inclusion in this table does not establish eligibility or approval. Confirm allowable expenses, cost allocation, and required documentation with the administering organization before committing funds.
How is RHTP funding different from reimbursement for patient care?
RHTP funding should not be treated as another payer for services already reimbursable by insurance. CMS specifies that funding cannot replace or modify payment for clinical services that could be reimbursed through insurance or other health coverage. It also restricts duplication and replacement of existing funding, so practices need to distinguish approved transformation expenses from ongoing billable care.
Before launch, ask the project administrator and billing team to review how expenses and services will be recorded. Identify the documentation needed to show which funding source supports each activity. A project budget should make that separation visible instead of assuming that an unpaid claim can be shifted to the award.
Care coordination is also broader than any single billing service. Calling an activity care coordination does not establish that it qualifies as Chronic Care Management, Principal Care Management, or another reimbursable service. If your sustainability plan relies on reimbursement, verify the current requirements for the service, payer, practitioner, and practice setting.
What does the operating plan need to cover?
Funding can help a practice begin a project, but it does not assign responsibility for the daily work. The operating plan should follow the patient from identification through enrollment, participation, clinical follow-up, and documentation. Each handoff needs a person or team responsible for completing it.
Patient identification and enrollment
Define which patients the clinical team intends to serve and how that population fits the project’s purpose. Assign responsibility for outreach, explaining participation, documenting required consent, and following up with patients who do not respond. Plan for language, accessibility, caregiver involvement, and the questions patients may have about costs or contact from an outside team.
Device setup and ongoing participation
For RPM, decide who will coordinate delivery, help patients activate devices, and confirm that readings reach the intended system. Test connectivity and usability in the communities the project will serve rather than assuming that equipment will work equally well in every home. Someone also needs to investigate missing readings and resolve technical problems after enrollment.
Clinical review and care coordination
Assign responsibility for reviewing information, contacting patients, and routing concerns to the appropriate clinician. Specify how the receiving team acknowledges a handoff and follows through when a referral, medication question, or change in symptoms needs attention. Confirm service hours and backup arrangements so patients and staff understand what support is available.
Documentation and project reporting
Clinical records, billing support, and award reporting may require different information. Identify where each record will live, who checks its completeness, and how the practice will obtain information from any partner. Choose measures that help the team manage the operation while also meeting the project’s reporting requirements.
Who owns the work in a rural RPM and care-coordination program?
| Responsibility | Practice's role | Potential partner's role | Handoff to define |
|---|---|---|---|
| Patient identification | Determine clinical appropriateness and confirm alignment with the project's intended population. | Help organize candidate lists using practice-approved criteria and authorized information. | Who approves patients for outreach, and how are exclusions or changes communicated? |
| Enrollment | Approve the participation explanation, consent workflow, and handling of patient questions. | Conduct agreed outreach, document participation decisions, and follow up with patients. | Where is enrollment status recorded, and who resolves unanswered questions or incomplete consent? |
| Device delivery | Confirm the appropriate device and the practice's role in distribution or inventory. | Coordinate contracted fulfillment, delivery tracking, and shipping exceptions. | Who confirms receipt and resolves an undelivered, incorrect, or damaged device? |
| Device activation | Identify patient support needs and approve the device-use instructions. | Provide agreed setup assistance and confirm that readings reach the intended system. | Who follows up when a delivered device has not been activated? |
| Connectivity support | Help determine an appropriate care approach when technical barriers persist. | Troubleshoot transmission issues and coordinate technical support within scope. | Who owns unresolved problems, replacement decisions, and confirmation that transmission resumes? |
| Missing-reading follow-up | Approve follow-up expectations and address clinical concerns identified during outreach. | Investigate gaps, contact patients, and document findings within the agreed workflow. | When does an unresolved gap reach the practice, and who follows it through to resolution? |
| Clinical review | Set clinical direction, assign qualified reviewers, and retain treatment decisions. | Perform contracted review and patient outreach where permitted by applicable requirements. | Who reviews information, during which hours, and how are findings communicated? |
| Escalation | Approve escalation procedures and provide designated clinicians and backup contacts. | Route concerns through approved channels and track acknowledgment within scope. | What happens when a concern is not acknowledged or occurs outside agreed service hours? |
| Care coordination | Direct the care plan and handle decisions requiring the treating clinician. | Support agreed follow-up, referral tracking, and communication with patients and care teams. | Who checks whether the next care step occurred and resolves incomplete follow-up? |
| Documentation | Define record requirements, access needs, and the process for correcting incomplete information. | Document contracted activities and make records available through the agreed process. | Where do records live, when are they available, and who resolves discrepancies? |
| Billing handoffs | Assign billing review, claim submission, and denial follow-up; distinguish billable care from award-funded expenses. | Supply supporting activity records and perform only the billing functions included in the agreement. | Who checks service requirements, corrects missing records, and reviews potential funding overlap? |
| Award reporting | Confirm reporting obligations and coordinate with the entity accountable under the award. | Provide agreed activity data, deliverable records, and itemized invoices needed for project reporting. | Who validates and submits reports, by which deadlines, and using which data definitions? |
This table is a planning framework, not a statement of funding eligibility or a 1bios service commitment. Partner responsibilities depend on the contracted scope, qualifications, award terms, and applicable clinical and payer requirements. Assign a named owner to every task and handoff before launch.
Should the practice build internally or work with a partner?
The funding opportunity and the operating model need to fit together. A practice may have strong clinical capacity but need help with enrollment or device logistics, while another may need broader operational support. Evaluate internal, hybrid, and managed approaches against the same list of responsibilities and the award’s contracting requirements.
An internal model can fit a practice with available staff, management capacity, and dependable backup coverage. It gives the practice direct control over day-to-day work. The budget still needs to account for training, supervision, technology, administration, and the work employees would otherwise perform.
A hybrid model can address a defined gap while keeping selected functions inside the practice. For example, a partner might support onboarding and technical troubleshooting while practice staff retain clinical review. The division should be specific enough that both teams know who owns unresolved issues.
A managed model can provide a broader operating scope when the practice lacks capacity to build every function itself. The practice still needs clinical direction, provider responses, oversight, and access to records. Confirm the arrangement’s fit with award terms and current payer requirements rather than assuming that funding approval also establishes billing eligibility.
For a closer comparison, see RPM software vs. fully managed RPM and in-house vs. outsourced CCM. These decisions involve different workflows, so an RPM staffing plan should not automatically be reused for CCM. The partner’s scope and the practice’s retained work should reflect the services actually being delivered.
Operational example: Expanding follow-up into another rural community
Consider a practice that wants to extend monitoring and care coordination to patients in a community it has struggled to reach consistently. Its proposed project includes onboarding support, connected devices, staff training, and a defined follow-up workflow. Before purchasing anything, the practice asks the state administrator which parts of that expansion fit the initiative and how each expense should be allocated.
CMS illustrates this distinction through an example of expanding a chronic disease management program into additional counties: funding may support qualifying new populations, activities, and milestones, while existing program costs remain with their original funding sources. That example is not blanket approval for a practice’s proposal. The state opportunity and approved budget still govern the project.
The operational test comes when a newly enrolled patient stops transmitting readings. Someone must contact the patient, investigate the gap, address technical issues, and involve the clinician if the conversation identifies a care concern. The project needs a plan for performing that work during the award and paying for it afterward.
How should practices plan for operations after funding ends?
Before launching, identify who will perform the recurring work, what it will cost, and which verified funding sources will support it after the award ends. Separate implementation work from recurring expenses such as staffing, connectivity, software, device replacement, supervision, and administration. CMS also expects initiatives to address sustainability beyond the program period.
Identify a supported source for recurring costs
For each continuing expense, identify a realistic funding source and the assumptions behind it. Potential sources to evaluate include applicable reimbursement, an executed value-based arrangement, committed organizational support, or another documented funding source. Do not count anticipated collections or a future partnership as committed revenue.
Budget for participation and workload
The number of devices purchased will not tell you how many patients remain engaged or how much staff time the program requires. Include enrollment follow-up, unsuccessful contact attempts, technical support, clinical review, documentation, and management in the operating budget. Revisit those assumptions using actual project experience before expanding enrollment.
Set decisions before temporary support expires
Agree on when the organization will review costs, participation, operational performance, and available ongoing funding. Define who decides whether to continue, adjust, expand, or wind down the program. If services must change, plan for patient communication, clinical handoffs, records access, and device responsibilities before the funding runs out.
Planning for operations after RHTP funding ends
| Cost category | Launch costs to assess | Recurring costs | Ongoing funding to verify | Assumptions to validate | Suggested decision owner |
|---|---|---|---|---|---|
| Staffing and patient support | Recruitment, onboarding, training, and workflow development. | Enrollment, outreach, clinical review, technical support, benefits, and backup coverage. | Approved staffing budget supported by validated collections, committed organizational funds, or an executed care-delivery agreement. | Patient participation, actual workload, staff availability, turnover, and contracted service scope. | Practice administrator with clinical leadership. |
| Platform and connectivity | Configuration, interfaces, access setup, and technical testing. | Licenses, device connectivity, maintenance, and contracted technical support. | Approved technology budget or a documented allocation from the ongoing program budget. | Renewal pricing, minimum commitments, active-user charges, connectivity reliability, and data access. | Technology lead with finance. |
| Devices and replacement | Initial equipment, shipping, inventory setup, and activation support. | Replacement devices, supplies, shipping, returns, and equipment for new participants. | Approved equipment reserve or an ongoing service agreement with explicit device provisions. | Ownership, useful life, warranties, loss or damage, compatibility, and replacement charges. | Operations lead with finance. |
| Supervision and oversight | Clinical workflow approval, escalation planning, and partner onboarding. | Clinical oversight, quality review, staff management, and partner performance review. | Committed clinical and administrative capacity within the recurring operating budget. | Protected management time, backup arrangements, retained practice duties, and review frequency. | Clinical director with practice administration. |
| Documentation | Templates, record-access setup, documentation standards, and staff training. | Recording activities, checking completeness, correcting gaps, and maintaining accessible records. | An explicit allocation in the staffing, technology, or contracted-service budget. | Time per workflow, system access, partner deliverables, record retention, and correction workload. | Program manager with clinical and records leads. |
| Billing administration | Payer review, billing workflow setup, and funding-allocation procedures. | Service verification, claim submission, corrections, denial follow-up, and collections review. | Approved revenue-cycle budget based on realistic collections and any committed organizational support. | Payer mix, applicable service requirements, denials, payment timing, and billing-service fees. | Revenue-cycle lead with finance. |
| Reporting and evaluation | Baseline measures, data definitions, reporting tools, and responsibility assignments. | Data validation, performance review, required award closeout, and any continuing reporting obligations. | Documented funding for remaining award obligations and an approved budget for ongoing program evaluation. | Reporting deadlines, post-award obligations, data availability, partner access, and staff effort. | Award lead with quality and finance teams. |
This is a budgeting framework, not a determination of allowable RHTP expenses or guaranteed reimbursement. Replace suggested roles with named owners and verify each funding source, restriction, and contract term. Count bundled expenses only once, and do not treat projected collections as committed revenue.
Where 1bios fits
1bios brings a connected-care operating perspective to the build-versus-partner decision. Its RPM offering includes enrollment support, device logistics, technology, care-team support, and billing assistance. A practice exploring an RHTP-supported project should compare its operational needs with a clearly defined service scope.
Start that discussion with your intended patient population, existing staff capacity, and the work your team needs help completing. Define what the practice will retain, what a partner would perform, and what the ongoing arrangement would cost. Any use of RHTP funds for those services must be reviewed under the specific state opportunity and award terms.
Related articles
- In-house vs. outsourced CCM: Staffing, cost, control, and tradeoffs
- RPM software vs. fully managed RPM: Which model fits your practice?
- Why RPM and CCM programs fail at enrollment
Frequently asked questions
RHTP questions often combine funding eligibility with decisions about delivering patient care. Those decisions are related, but they require different evidence. Use the state’s official instructions for funding questions and a documented operating plan for implementation.
Can rural practices apply directly to CMS for RHTP funding?
Under the program’s eligibility requirements, the direct federal awards are for states. A practice should look for participation opportunities through its state’s program or an organization administering a relevant initiative. Confirm the application route and eligible entity types in the specific notice.
Does an RPM vendor’s participation guarantee funding eligibility?
A vendor’s involvement does not establish that a practice or proposed expense qualifies. Ask the administering organization to evaluate the project scope, budget, and proposed vendor arrangement. Obtain that determination before making commitments that depend on funding.
Can RHTP funding support an existing program?
CMS distinguishes qualifying expansion from replacing an existing program’s funding. A proposal should identify the new population, activity, or milestone and separate its costs from existing operations. Confirm the proposed allocation with the state administrator.
Is it too late for a practice to participate?
Check the current notices for your state and the initiative relevant to your project. A past federal application deadline for states does not tell you whether a provider opportunity is open today. Ask the administrator about current opportunities, partner participation, and any announced future rounds.
What should a practice prepare before contacting a potential operating partner?
Prepare a description of the patients you intend to serve, the state opportunity you are considering, and your current staffing and technology. Identify the functions you want to retain and the gaps you need help addressing. Bring a preliminary recurring-cost budget so the discussion covers sustainability as well as launch.