Vermont's Rural Health Transformation Program is in active implementation, guided by five strategic initiatives to strengthen the rural health workforce, expand timely access to care, and deploy innovative, quality-driven strategies. Managed by the Vermont Agency of Human Services with CMS funding, the program coordinates 35 activities focused on care modernization, workforce development, and system integration throughout rural communities. Current structured plan tracks 10 key initiatives and 7 strategic goals.
Vermont has received federal funding and formally launched the Rural Health Transformation Program. Multiple procurements, including RFP #142 for urgent mental health care in Rutland County and NOFOs for Mobile Integrated Healthcare, are posted and active, with applicants participating in bidders conferences and addenda released. The application processes for subawards are underway, and grant contracting is scheduled for summer 2026. State opportunities: 4 active (1 open, 1 upcoming, 2 closing soon, 16 past/closed), $9.0M listed funding. State opportunities: 4 active (1 open, 1 upcoming, 2 closing soon, 16 past/closed), $9.0M listed funding. Key opportunities: Mental Health Urgent Care- Rutland County; Rural Health Transformation Program - Centralized Tool to Guide Interfacility Transfers; Rural Health Transformation Program - Facility Upgrades to Support Regionalization. Strategy alignment: supports workforce, care access priorities.
RHTP Strategy
Vermont’s RHTP pursues comprehensive rural health transformation through the AHEAD model, leveraging $195 million in CMS funding to execute 35 activities across five strategic initiatives. The approach integrates targeted facility and IT upgrades, regionalization, mobile integrated healthcare, and urgent mental health care, supported by robust performance monitoring and highly structured competitive procurements. Priority is placed on broad provider participation, care model innovation, and interagency collaboration, underpinned by transparent stakeholder engagement and sustained federal oversight. The five-year strategy (2025–2030) aligns infrastructure, service delivery, and workforce investments to improve access, quality, and sustainability statewide.
Model
AHEAD (Achieving Healthcare Efficiency through Accountable Design) Model
Key Initiatives
1Comprehensive facility upgrades—minor renovations, accessibility improvements, and equipment/IT modernization—focused on regionalizing services and promoting integrated care
2Implementation and statewide scaling of mobile integrated healthcare (MIH), fostering clinical and administrative partnerships between EMS agencies, FQHCs, hospitals, and other providers
3Provider-driven proposals for regional service hubs and new community-centered care models, including phased and multi-year projects
4Deployment and use of a centralized interfacility patient transfer tool to streamline regional collaboration and care transitions
5Launch of urgent, walk-in mental health support services—without appointments—in priority rural areas such as Rutland County
6Expansion and support for workforce development and retention pipelines, including targeted rural recruitment and upskilling
7Promotion of health system partnerships and sustained integration efforts among healthcare providers, EMS, and community agencies
8Milestone-based performance monitoring and outcome-based reporting for all funded activities
9Ongoing stakeholder engagement via advisory committees, public input sessions, and transparent procurement and funding processes
10Require applicants to justify all budget line items and enforce prohibition on supplanting existing funding through standardized budget submissions
Timeline: December 2025–October 2030 (major procurements and NOFOs close by August 2026; Year 1 implementation and grant execution from September 2026–July 2027; five-year program performance period aligned to CMS funding)
Health Priority
Mental Health Urgent Care: Rutland County is a focus region for mental health urgent care, highlighted by a dedicated RHTP opportunity. (Regions: Rutland County)
Jul 15, 2026
Health Priority
Interfacility Transfers: Centralized tools are in development to improve care coordination for rural patients needing transfers between facilities.
Jul 15, 2026
Program Update
This document provides the required budget template for applicants to Vermont's RHTP facility upgrade, care transformation, and interfacility transfer solicitations. Applicants must ensure compliance with funding restrictions, especially prohibitions on supplanting existing sources, and thoroughly justify all line item requests.
Jul 14, 2026
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VT - 2025 - RHTP Application Activity Details | Health Care Reform
VT - 2026 - Mental Health Urgent Care- Rutland County
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VT - 2026 - 6.3.6. Attachment G – State of Vermont – Federal Terms Supplement - Non-Construction (December 30, 2024) Revised: February 13, 2026 Page 15 of 15
This addendum provides access to a recorded meeting and transcript for applicants and stakeholders of the Mobile Integrated Healthcare Implementation Services NOFO. It is intended to ensure equitable access to procurement information.
This Q&A document clarifies applicant eligibility, allowable uses, and facility upgrade scope for Vermont's Rural Health Transformation Program Facility Upgrades RFP. Eligible providers include hospitals, clinics, home health, hospice, FQHCs, mental health, substance use disorder providers, and community pharmacies. Upgrades must support regionalization and integrated care delivery, with a focus on minor renovations, accessibility, and clinical infrastructure.
Event schedule:
- Questions Deadline - 06/26/2026
- Application Deadline - 07/17/2026
- Grant Commencement Date - 09/01/2026
- Year 1 Funds Must Be Expended By - 07/30/2027
QUALITY_IMPROVEMENT · NETWORK_DEVELOPMENT · HEALTH_INFORMATION_TECHNOLOGY · OTHER
Event Schedule
Questions Deadline - 06/26/2026
Application Deadline - 07/17/2026
Grant Commencement Date - 09/01/2026
Show all schedule items (4)
Questions Deadline - 06/26/2026
Application Deadline - 07/17/2026
Grant Commencement Date - 09/01/2026
Year 1 Funds Must Be Expended By - 07/30/2027
Core Initiatives
Advance regionalization of healthcare services in rural Vermont
Support integrated care delivery and shared operations
Improve infrastructure and accessibility of rural health facilities
Event schedule:
- Addendum #1 , 2026 Informational Meeting: A non-mandatory informational meeting will be held on Friday, June 26, 2026, from 11:00- 12:00 PM Eastern time. The meeting will be held remotely via Microsoft Teams. Informat...
This document summarizes FY26 RHTP applications for multiple states. States describe major investments (over $150M each) in maternal and chronic disease care, telehealth, mobile health units, workforce pipelines, and value-based care. Strategies emphasize regionally-coordinated efforts, technology upgrades, expanded clinical rotations, and stronger data sharing to transform rural health delivery.
Core Initiatives
Improve healthcare access and outcomes in rural communities
Expand workforce capacity and training
Enhance technology integration and care coordination
Show all initiatives (46)
Improve healthcare access and outcomes in rural communities
Expand workforce capacity and training
Enhance technology integration and care coordination
Increase focus on maternal, behavioral, and chronic disease health
Stabilize rural hospitals and ensure population health improvements
Empower rural Mainers to achieve their own healthy living goals through expanded population health solutions
Expand the supply of care by growing a rural workforce and spreading technologies that improve coordination
Ensure care will be available and affordable long into Maine’s future by pairing affordability measures with strategies that advance quality, efficiency, and fiscal durability
Transform the rural health workforce through new apprenticeships, improved IT, and expansion of Area Health Education Centers, and pipeline programs (Maryland)
Promote sustainable access and innovative care through new and expanded capacity for primary care, specialty practices, school-based health centers, and behavioral health expansion (Maryland)
Expand access to essential healthcare services for rural residents and reduce hypertension and diabetes ED visits (Massachusetts)
Strengthen the foundation of rural health systems through integrated, community-driven solutions and workforce development (Michigan)
Improve cardiometabolic health outcomes and recruit and retain talent in rural communities (Minnesota)
Conduct a statewide assessment of rural health needs and transform rural healthcare delivery through Coordinated Regional Integrated Systems (Mississippi)
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SummaryApr 16, 2026PDF2026
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SummaryApr 16, 2026PDF2026-2030
Vermont submitted its Rural Health Transformation Fund application for federal funding covering 2026-2030. The application focuses on strengthening rural health networks through coordination, technology sharing, workforce support, and affordability. Exact award amounts are yet to be determined by federal review.
Core Initiatives
Report Documents (1)
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ReportJun 15, 2026PDF2026
This progress report details significant organizational restructuring at University of Vermont Health Network, resulting in $8.1 million in annual savings, as well as the commissioning of two consultant studies to optimize clinical operations and forecast fiscal sustainability. It also recounts ongoing negotiations to implement value-based care contracts with BCBS VT and the state's effort to address affordability, quality, and population health. The Liaison Team continues to oversee progress, aiming to inform and guide Vermont's rural health transformation strategy.
Event schedule:
- Consultant studies begin - 01/01/2026
- Consultant studies complete - 03/31/2026
- Liaison Team project completion estimated - Fall 2026
FINANCE · QUALITY_IMPROVEMENT · OTHER · POPULATION_HEALTH · NETWORK_DEVELOPMENT
Event Schedule
Consultant studies begin - 01/01/2026
Consultant studies complete - 03/31/2026
Liaison Team project completion estimated - Fall 2026
Core Initiatives
Improve affordability and sustainability of health care for Vermonters.
Streamline organizational structure and reduce duplication within the UVMH network.
Enhance quality and accessibility of patient care.
Show all initiatives (5)
Improve affordability and sustainability of health care for Vermonters.
Streamline organizational structure and reduce duplication within the UVMH network.
Enhance quality and accessibility of patient care.
Advance value-based care models and infrastructure.
Strengthen fiscal accountability and transparency.
Data Documents (8)
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DataApr 28, 2026PDF2025-2027
Vermont is advancing a statewide rural health transformation strategy under Act 68 of 2025, building on prior community engagement and legislative mandates. Fourteen hospitals are engaged in shared services, care shifts to appropriate settings, analytics, and service line optimization. The state is broadening efforts to include primary care and community provider transformation, aiming for a sustainable, equitable rural health system.
Core Initiatives
Develop a comprehensive, affordable, and sustainable rural health care system statewide.
Engage all hospitals and expand transformation to primary care and community providers.
Optimize resource allocation, improve efficiency, maintain access, and promote equity.
Show all initiatives (4)
Develop a comprehensive, affordable, and sustainable rural health care system statewide.
Engage all hospitals and expand transformation to primary care and community providers.
Optimize resource allocation, improve efficiency, maintain access, and promote equity.
Implement shared services and shift care to appropriate lower-cost settings.
Vermont's rural hospitals are pursuing multifaceted transformation strategies tailored to local needs, with emphasis on cost containment, specialist access, interoperability, and population health. Collaborative purchasing and network approaches are used to help achieve financial sustainability. No explicit funding allocations or award amounts are identified in this strategy document.
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DataApr 25, 2026HTML
The Vermont RHTP is funded with a grand total of $195,053,740 and managed by the Human Services Vermont Agency. The program's period of performance spans from December 29, 2025, to October 30, 2030. The award is classified as discretionary and is focused on rural health transformation.
Event schedule:
- Period of Performance Start - 12/29/2025
- Period of Performance End - 10/30/2030
This document provides the required budget template for applicants to Vermont's RHTP facility upgrade, care transformation, and interfacility transfer solicitations. Applicants must ensure compliance with funding restrictions, especially prohibitions on supplanting existing sources, and thoroughly justify all line item requests.
This document presents a detailed financial analysis of funds flowing between New York residents/providers and the University of Vermont Health Network entities, including provider taxes and federal match flows, as well as reinvestments back to New York health organizations. It includes FY2024 budget data and summary metrics showing the net positive impact of these cross-state health sector flows for Vermont. No direct RHTP awards or procurement opportunities are stated within.
This document is an addendum to the Vermont Rural Health Transformation Program subrecipient grant regarding telehealth technology adoption, specifying corrections and compliance updates.
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed.
Q&A for Activity 18 .pdf
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VT - 2026 - Physician Transfer Schedules A & B
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FY2020 Hospital Budget Guidance Final as of 2019-03-27 updated 4 8 19.pdf
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VT - 2026 - Appendix A RHTP Subrecipient Grant Budget Template.pdf
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VT - 2026 - RHTP Transform, Innovate, and Regionalize Care NOFO (RHT_AHSCO_0008_FY26)
VT - 2026 - RHTP Transform, Innovate, and Regionalize Care NOFO (RHT_AHSCO_0008_FY26)
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Appendix A RHTP Subrecipient Grant Budget Template.pdf
This guidance clarifies that Federally Qualified Health Centers may serve as lead applicants or partners in MIH site applications for Vermont's program, provided all NOFO requirements are met. The Vermont Department of Health emphasizes the importance of sustainability and outlines updated grant timeline deadlines, including earlier grant closeout and spending dates. Grant execution period is set from August 1, 2026, through July 30, 2027.
Event schedule:
- NOFO Posting Date - June 11, 2026
- Information Conference - June 26, 2026 - 11:00 AM ET
- Letters of Interest due to VDH - July 10, 2026 - 4:30 PM ET
- VDH review Letters of Interest - July 13 – August 14, 2026
- Negotiations with grantees - August 17 – August 28, 2026
- All grantees notified of award - August 28, 2026
- All subrecipient grants executed and funds obligated - September 2026
- Oversight, monitoring, and evaluation - September 2026 – June 2027
EMS_DEVELOPMENT · POPULATION_HEALTH · OTHER
Event Schedule
NOFO Posting Date - June 11, 2026
Information Conference - June 26, 2026 - 11:00 AM ET
Letters of Interest due to VDH - July 10, 2026 - 4:30 PM ET
Show all schedule items (9)
NOFO Posting Date - June 11, 2026
Information Conference - June 26, 2026 - 11:00 AM ET
Letters of Interest due to VDH - July 10, 2026 - 4:30 PM ET
VDH review Letters of Interest - July 13 – August 14, 2026
Negotiations with grantees - August 17 – August 28, 2026
All grantees notified of award - August 28, 2026
All subrecipient grants executed and funds obligated - September 2026
Oversight, monitoring, and evaluation - September 2026 – June 2027
Year-1 funds fully spent - July 30, 2027
Core Initiatives
Expand integrated healthcare service delivery in rural Vermont
Foster partnerships between EMS agencies and healthcare facilities
Develop sustainable funding methodology for MIH sites
The Vermont RHT NOFO supports subrecipient activities to transform, innovate, and regionalize care in rural areas. Eligible applicants include hospitals and nonhospital providers physically located in Vermont. Funding proposals may include workforce development, EMR/telehealth technology, service innovations, and regional partnerships. CMS approval and compliance with state procurement guidelines are required, and funding is limited to 12-month award terms.
Event schedule:
- NOFO Award Term Start - 09/01/2026 - Vermont
- NOFO Award Term End - 07/30/2027 - Vermont
Transform rural health service delivery in Vermont
Innovate care models and regionalize services
Support development and sustainability of rural providers
Event Schedule
Addendum #1 , 2026 Informational Meeting: A non-mandatory informational meeting will be held on Friday, June 26, 2026, from 11:00- 12:00 PM Eastern time. The meeting will be held remotely via Microsoft Teams. Informat...
This memorandum provides an in-depth review and critique of the proposed 2026 University of Vermont Health Network budget, emphasizing increasing costs, high administrative overhead, and a lack of realized affordability for Vermonters. The report recommends establishing explicit affordability metrics, aligning incentives toward primary care, and streamlining GMCB’s budget review process to improve accountability and transparency. The analysis flags the risk that high and rising hospital expenses may outpace reimbursement system reforms, undercutting the effectiveness of rural health transformation unless core financial drivers are addressed.
Event schedule:
- GMCB Budget Hearing - 08/13/2025 - ET - Vermont (location per GMCB)
Budget: $2.9BFINANCE · POPULATION_HEALTH · OTHER
Event Schedule
GMCB Budget Hearing - 08/13/2025 - ET - Vermont (location per GMCB)
Core Initiatives
Improve affordability of healthcare for Vermonters
Promote financial sustainability of Vermont hospitals
Increase transparency and accuracy of hospital budget assumptions and reporting
Show all initiatives (4)
Improve affordability of healthcare for Vermonters
Promote financial sustainability of Vermont hospitals
Increase transparency and accuracy of hospital budget assumptions and reporting
Streamline and focus the budget review process on meaningful data and outcomes
Build a statewide network of rural healthcare hubs to expand access to care, improve healthcare outcomes, and empower rural communities to design and lead locally tailored health care solutions (Missouri)
Strengthen healthcare workforce, secure financial solvency for rural providers, embed prevention and community health at the center of care, and expand technology use (Montana)
Make Rural America Healthy Again focusing on food-as-medicine, workforce development, technology initiatives, and right-sizing the healthcare system (Nebraska)
Make Rural Nevada Healthy Again by implementing value-based care models to prevent and manage chronic disease, strengthen rural systems through investments and workforce recruitment (Nevada)
Improve quality of life through access to primary and preventative care, behavioral health services, oral health care, and strengthening the rural health workforce (New Hampshire)
Improve healthcare availability by investing in primary and specialty providers, supporting CCBHCs, and fostering a flexible healthcare system (New Jersey)
Transform healthcare access and quality through specialty care access, chronic disease management, value-based payments, and workforce recruitment (New Mexico)
Improve health outcomes through Make Rural America Healthy Again and primary care initiatives, including partnership networks and workforce development (New York)
Catalyze innovative care models and transform the rural care experience through community care networks and expanding behavioral health and substance use disorder services (North Carolina)
Rebuild and retain rural health workforce through residencies, workforce pipelines, new technologies, wellness initiatives, and telehealth hubs (North Dakota)
Improve access to care through clinically integrated networks (CINs), community-based clinics in K-12 schools and college campuses to provide comprehensive improvements, and home visits.
Improve health outcomes through expansions of behavioral health services.
Improve chronic disease health outcomes such as reduced A1C and increased levels of hypertension management.
Expand technology to build remote monitoring and telehealth, expand electronic medical record (EMR) usage for pharmacists, and pilot innovative screening technologies for chronic disease.
Build a future where every community – no matter how small or remote – has access to high-quality, locally grounded care that is connected through technology, supported by regional collaboration, and sustained by a strong rural workforce.
Reduce preventable hospitalizations and emergency department visits year over year.
Improve health outcomes in chronic disease and poor maternal and child health outcomes.
Advance whole-person health through connected care technologies and coordinated pathways for behavioral health, chronic disease, maternal health, and social needs.
Promote sustainable access by focusing on integration and comprehensive delivery of services, leveraging technology, and supporting the workforce.
Increase adoption of paramedicine programs at EMS agencies.
Strengthen the workforce, expand clinical placements and policies that allow top-of-license practice.
Increase healthcare access and quality for improved chronic disease management and health outcomes for rural communities.
Prioritize direct investment in provider capacity over creating new programs by supplying practical tools and support.
Address transportation burdens in rural areas via integrated, technology-enabled transportation coordination systems.
Reduce Texas non-metro ratio of population to community health workers (CHWs).
Increase number of primary and specialty care providers in rural areas.
Build robust rural networks through enhanced primary and long-term care support with improved bed tracking and patient transfer systems.
Food as Medicine: provide infrastructure and startup costs for food pharmacy and programs including medically tailored meals and produce prescriptions for food-insecure patients.
Address substance use disorder, workforce turnover, and emergency room strain by expanding rural health networks and investing in technological infrastructure.
Improve the workforce, leverage technology, and improve healthcare system sustainability by addressing geographic barriers and increasing local mobility options.
Focus on care coordination, mental health support, leveraging technology, and workforce development in rural agricultural communities.
Increase access to care by focusing on rural clinical workforce, technology adoption, and right-sizing the delivery system.
Vermont's application details an ambitious transformation of rural health care through 30 proposed initiatives and grant programs targeting regionalization, integrated shared service platforms, stronger primary care, and major investments in rural provider and workforce development. The state will fund both service delivery reforms and physical facility and IT modernization, emphasizing EMS/paramedicine, mobile units, analytics, telehealth, housing, workforce pipelines, and more. Large-scale system assessment, independent evaluation, and insurance competition/transparency strategies ensure a data-driven, accountable transformation.
Regionalization and innovative care strategies to shift services and strengthen rural care delivery.
Establish a clinically integrated network of shared services.
Strengthen primary care statewide and improve team-based, preventive interventions.
Show all initiatives (5)
Regionalization and innovative care strategies to shift services and strengthen rural care delivery.
Establish a clinically integrated network of shared services.
Strengthen primary care statewide and improve team-based, preventive interventions.
Expand and develop the health care workforce in rural Vermont.
Promote price transparency and insurance market competition to improve access and affordability.
Build stronger rural health networks
Share technology and services to lower costs
Strengthen Vermont's rural health workforce
Show all initiatives (4)
Build stronger rural health networks
Share technology and services to lower costs
Strengthen Vermont's rural health workforce
Make health care more affordable and transparent
Core Initiatives
Increase access to specialists and primary care services for rural Vermonters.
Contain costs through shared purchasing, administrative alignments, and operational efficiencies.
Expand and sustain population health initiatives such as Mobile Integrated Health.
Show all initiatives (6)
Increase access to specialists and primary care services for rural Vermonters.
Contain costs through shared purchasing, administrative alignments, and operational efficiencies.
Expand and sustain population health initiatives such as Mobile Integrated Health.
Advance health information technology and interoperability across the hospital system.
Enhance care quality, safety, and transitions through redesign and workforce strategies.
Support hospital transformation for financial sustainability and regional system cooperation.
Period of Performance Start - 12/29/2025
Period of Performance End - 10/30/2030
This document is a Q&A supplement to Vermont's RFP for a Mental Health Urgent Care site serving Rutland County, fully federally funded under the Rural Health Transformation Program. The program will support innovative models delivered without appointments and tailored to rural community resource gaps. Restrictions on capital costs and billing are specified. Key contacts: Heather Sienkiewicz; Jeremy Therrien; Courtney Fitzpatrick
Event schedule:
- Bidders conference - 07/10/2026 - 10:00AM-11:00AM ET
QUALITY_IMPROVEMENT · POPULATION_HEALTH
Event Schedule
Bidders conference - 07/10/2026 - 10:00AM-11:00AM ET
Contacts
Heather Sienkiewicz - DMH - Statewide
Jeremy Therrien - DMH - Statewide
Courtney Fitzpatrick - DMH - Statewide
Core Initiatives
Increase access to urgent mental health care in rural areas
Support transformation of rural health through federally-funded initiatives
Address the specific mental health needs of Rutland County
FINANCE
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Vermont H E A L T H P O L I C Y Marketplace Premiums In 2025 Insurer And Provider Concentration Contributes To Wide Variation In Rates John Holahan, Noah Kennedy, And Michael Simps
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