Colorado

Colorado was awarded over $200 million in federal funds under the Rural Health Transformation Program for the 2026-2030 period. The funds will strengthen prevention, chronic disease management, workforce recruitment and retention, health IT, and new models of care. No state match is required, and funding is 100% federal. Key contacts: hcpf_RHTP@state.co.us Event schedule: - Award announcement - 12/31/2025 - Notice of Award received from CMS - January 2026 - CMS budget approval - April 2026 - RHTP Webinar for stakeholders - 12/02/2025

The Rural Health Transformation Project (RHTP) Advisory Committee reviewed the recently approved state budget for rural health transformation, including a planned $165 million RFA for rural community investments. Planning includes strong engagement with tribal nations, rural health clinics, and public health, with attention to data and tribal sovereignty. Standing monthly meetings have been scheduled to support program development and oversight. Key contacts: Erin Ulric; Michelle Mills; Courtney Roy; Cristen Bates cristen.bates@state.co.us Event schedule: - Regular Advisory Committee Meeting - 06/24/2026 - 10:00 AM MT - TBD (Standing virtual/in-person per schedule) - Advisory Committee Monthly Meeting Schedule Begins - June 2026 - 10:00 AM MT - Recurring, standing invite - First educational webinar release - 2024-05 - Virtual - New Monday committee meeting schedule start - 2024-06-03

Colorado was awarded over $200 million in RHTP funds for 2026 to support a wide range of rural health transformation projects including workforce development, telehealth, EMS improvements, value-based payment supports, and chronic disease prevention. The program aims to improve equity, access, and health outcomes for rural populations. Key contacts: hcpf_rhtp@state.co.us

Colorado's RHTP Year 1 application requests over $200M for rural health transformation, emphasizing population health, provider financial stability, workforce, network integration, data/IT, EMS, and hospital solvency. Substantial funds will flow to contracts for facilitation, provider/admin support, health IT innovation, and technical analysis. Ten initiatives with defined strategic goals align to CMS priorities including value-based care, provider readiness, tech adoption, and workforce growth.

This document defines rural eligibility for the Colorado Rural Health Transformation Program (RHTP) and details which ZIP codes in Weld, Larimer, and Mesa counties are considered rural under HRSA/FORHP standards. Applicants must provide service address and census tract information to verify their rural status. The guidance aims to ensure only federally designated rural sites are eligible for RHTP funding.

Colorado RHTP will invest over $200 million in year one to transform rural health care through 10 statewide initiatives, including telehealth, workforce expansion, chronic disease prevention, EMS and hospital stabilization, and value-based care pilots. The plan covers all 52 rural and frontier counties, two Tribes, and commits to reducing telehealth access gaps and strengthening rural hospitals and workforce by FFY2031. Event schedule: - Planning and early launch of rural chronic disease prevention programs - 2026 - Colorado - Development and launch of rural health networks, EMS, and hospital readiness programs - 2026 - Colorado - Health workforce needs assessment and curriculum planning - 2026 - Colorado - Vendor engagement for value-based care model design - 2026 - Colorado - Development of telehealth and technology integration project plan and pilot grants - 2026 - Colorado

The document summarizes FY26 Rural Health Transformation Program applications from numerous states, each proposing major initiatives for workforce, infrastructure, care access, technology, and value-based delivery. Key foci across states include maternal health, chronic disease, closing rural hospital sustainability gaps, building coordinated networks, and leveraging telehealth and innovative models. State strategies vary from mobile health units and residencies to coordinated care networks and digital infrastructure investments.

Colorado’s 2025-26 Healthy Colorado For All report showcases implementation milestones in immunizations, maternity, behavioral health, and prevention, emphasizing health equity and regional variation. Rural disparities remain pronounced, with 11% of Medicaid members in rural and 3% in frontier counties, half of rural areas classified as Maternity Care Deserts, and persistent differences in diabetes control and oral health by race/ethnicity. Major reforms include ACC Phase III launch, Medicaid eConsult platform, expanded doula services, and the approved HRSN (1115) waiver for broader social supports.

Colorado proposes a new State Directed Payment (SDP) program under CHASE, maximizing federal Medicaid support and potentially directing up to $378 million in additional reimbursements to hospitals. The strategy prioritizes both rural and urban providers by leveraging intergovernmental transfers, refined fee methodology, and quality measures. Implementation is targeted for July 2025, with annual model evolution and refinement.

Colorado's proposal for a State Directed Payment (SDP) program under Medicaid would drive an estimated $378 million in additional federal support to rural and urban hospitals through an MCO-directed model. The initiative is designed to maximize federal funds, enhance quality of care, and support coverage expansion while embedding rural hospital protections and quality reporting into the payment system. Implementation is targeted for July 1, 2025, pending CMS approval. Key contacts: Alison Sbrana; Annie Lee; Emily King; Josh Block Event schedule: - Proposed CMS submission date - 07/01/2025

Colorado HCPF is launching the ACC Phase III with more rural hospital and provider support, advanced value-based care, and targeted population health strategies. Major goals include controlling Medicaid cost trends, increasing automation in member renewals, expanding provider networks (especially for behavioral health and prenatal care), and protecting rural health system viability. The plan targets improved access and outcomes for rural, aging, and at-risk populations while navigating federal Medicaid changes.

Colorado's RHTP targets systemic transformation of rural health through a $1 billion five-year investment, addressing geographic, workforce, and financial barriers. Core strategies include expanding EMS, telehealth, workforce recruitment/retention, data integration, chronic disease/prevention programs, payment reform, and regionalized care coordination. The plan will strengthen rural hospitals’ sustainability, improve access to care, and reduce health disparities across all rural and frontier counties, prioritizing maternal, behavioral, and chronic disease outcomes.

The Governor of Colorado endorses the application for the CMS Rural Health Transformation Program, designating HCPF as lead agency. The plan prioritizes health equity, workforce development, innovative care delivery, stakeholder engagement, and sustainable access for rural residents. Specific strategies include technology upgrades, workforce training, expanding access to care, and partnerships with diverse stakeholder groups. Key contacts: Governor Jared Polis Event schedule: - , 2025 CMS Administrator U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services 7500 Security Boulevard, M/S B3-30-03 Baltimore, MD 21244 Subject: Governor’s Endorsement of the State of Colorado’s Rural Health Transformation Program Plan Dear CMS Administrator: As the Governor of the State of Colorado, I am pleased to provide this letter of endorsement for the Rural Health Transformation Plan (RHTP) submitted by Colorado to the Centers for Medicare & Medicaid Services (CMS) in response to the One Big Beautiful Bill Act (opportunity number CMS-RHT-26-001). I fully support and commit to this Rural Health Transformation plan to fuel a creative and impactful transformation of health care for rural residents across our state. The State of Colorado is dedicated to pursuing a collaborative approach with key stakeholders to achieve the following strategic goals: Make rural America healthy again; reducing chronic disease; sustainable access; workforce development; innovative care; and tech innovation. State Commitment and Lead Agency The State of Colorado recognizes the urgent need to strengthen and transform health care delivery and access for our rural communities. Through the Rural Health Transformation Plan, we will transform rural health care systems by improving the sustainability of providers, addressing health equity, and advancing innovative care delivery models. I hereby designate the Colorado Department of Health Care Policy & Financing (HCPF) as the lead agency responsible for submitting the application and implementing the State of Colorado’s plan. HCPF will leverage its experience in serving more than 21% of the state’s population, our partnerships with rural providers, and collaborative efforts with engaged Colorado stakeholders. This agency will coordinate all aspects of planning, stakeholder engagement, and program oversight in collaboration with key state and community partners. HCPF oversees the administration of Health First Colorado (Colorado’s Medicaid program) and numerous value-based programs that span the State of Colorado. The financial support available through this grant will enable Colorado to elevate CMS’s strategic goals and pursue transformative outcomes for our rural communities. Rural Health Transformation Program funding will be requested for federally-defined rural and frontier counties in Colorado that continue to identify significant needs and gaps in accessible health care. Our interest in funding is a direct response to rural community needs, as demonstrated by data - November 4 - supplied by the Colorado Rural Health Center and surveys from numerous providers and partners across the state. Collaboration and Stakeholder Engagement From the outset, my administration has made it a priority to ensure that the Colorado Rural Health Transformation is driven by the voices of rural Coloradans. The State will integrate stakeholder input directly into decision-making through a transparent and inclusive governance structure designed to reflect the diversity of our rural health ecosystem. We have engaged key stakeholders through our planning process via listening sessions, ideation and feedback sessions, webinars, surveys, and interviews. A comprehensive list of our application core working group includes the following participants: ● Colorado Rural Health Center ● Rural Health Care Providers ● State Tribal Affairs Office and ● Colorado Department of Public Health Representatives and Environment ● Colorado Hospital Association ● Office of eHealth Innovation, the ● Colorado Behavioral Healthcare State-Designated Entity for all Health Council IT Strategy, Policy, and Funding ● Colorado Community Health Network Coordination (Federally Qualified Health Centers ● All 4 Regional Accountable Entity [FQHCs]) CEOs ● FQHC CEOs ● The Emergency Medical Services ● Colorado Rural Futures Group Association ● Colorado Health Initiative ● Tribal Representatives ● Western Healthcare Alliance ● Consumer Advocate Representatives ● Eastern Plains Healthcare Consortium ● Other Key Stakeholders ● Rural Hospital CEOs I certify that stakeholder input has been incorporated into all stages of Colorado’s plan development and will continue throughout implementation of our Rural Health Transformation plan. Continued Stakeholder Engagement Through Implementation HCPF will maintain continuous stakeholder engagement by facilitating strategy and listening sessions with an Advisory Committee that represents key stakeholders from across Colorado’s rural health landscape. We will also conduct joint program evaluations, and integrate stakeholder recommendations into program modifications. This inclusive approach ensures transparency and ensures community-driven solutions to community-identified needs. Moving forward, the State of Colorado will continue to obtain stakeholder input by: ● Establishing an Advisory Committee that regularly represents rural providers, community leaders, and tribal partners. ● Hosting listening sessions and public forums on a regular basis to ensure comprehensive community engagement. ● Incorporating the feedback we obtain into policy, payment, and regulatory decisions during program implementation.

Care Solace acts as an RHTP infrastructure and care coordination partner, helping rural communities connect to mental and behavioral health care through technology-enabled and human-driven services. The company addresses social determinants such as transportation and housing and specializes in bridging access for mothers, Tribal members, and individuals facing mental health crises. Care Solace enables measurable RHTP outcomes by streamlining referral, access, and follow-up – serving as connective tissue for rural health networks.