Rural Health Transformation Program Readiness Checklist: 9 Areas That Make the RHTP Achievable

Here is your Rural Health Transformation Program readiness checklist. The Rural Health Transformation Program is a once-in-a-generation opportunity to reshape rural care. But the money alone won’t create impact, your readiness will. 

Have you asked yourself, “How prepared are we to transform our health center when the funds arrive?” 

The RHTP is a five-year, $50 billion federal investment designed to help states transform rural health care delivery – improving access, quality, and outcomes through innovation, workforce, and technology. States submit transformation plans to CMS and, if approved, will receive substantial funding from 2026 to 2030.

That means your state is (or soon will be) designing RHTP-funded opportunities. Health centers that show up with clear, grounded, implementation-ready plans will be first in line. 

This post is not a breakdown of every line in the statute. It’s a Rural Health Transformation Program readiness checklist for CEOs, CMOs, CDOs, and operational leaders who don’t just want to “chase a pot of money,” but actually use those dollars to transform care. 

Use these questions with your leadership team. If too many answers are “I’m not sure” or “we haven’t really talked about that,” you’re not ready yet and that’s exactly where the work needs to start. 

Here is your Rural Health Transformation Program Readiness Checklist.

Let’s get ready together.

1. Have we defined our vision across the four RHTP strategic goals? 

CMS and federal guidance frame the RHTP around several key areas, here are the four big themes:

• Sustainable access 
• Workforce development 
• Innovative care 
• Tech innovation 

Before you draft a single paragraph of a proposal, ask: 

• If we had meaningful new funding, what would “sustainable access” actually look like in our service area? 
  More appointments per day? A stronger dental program? Fewer no-shows? Extended hours? 

• What’s our long-term vision for workforce development? 
  Do we want defined career ladders, better onboarding, opportunities for growth, or all of the above? 

• What innovative care models do we want to build or scale? 
  School-based care, mobile clinics, embedded dental in medical, integrated behavioral health, a telehealth program? 

• How do we want technology to change daily life for our clinicians and patients, not just our IT budget? 
  Think: easier documentation, better decision support, tighter medical-dental integration, more proactive outreach, second-opinion tools. 

If you can’t articulate even a rough vision in each of these areas, your RHTP plan will end up being a string of buzzwords instead of a transformation roadmap. 

2. Do we have a clear strategy for each of the three “on-the-ground” pillars? 

Underneath those four federal goals, health centers will actually execute in three practical pillars: 

1. Transformative care models 

2. Technology and tools 

3. Workforce development and change management 

Ask yourself the following: 

• Transformative care models: 
  • Where are the biggest gaps today between what our community needs and what our current model can deliver? 
  • How will we break down silos between medical and dental health? 
  • If we want to expand dental access, what does true medical–dental integration look like in our clinics? 

• Technology and tools: 
  • Which tools actually move the needle on access, quality, and provider experience and which are shiny objects? 
  • Are we prioritizing clinical second-opinion tools, ambient note-taking, telehealth, and data infrastructure that support real care redesign? 

• Workforce and change management: 
  • Who will champion these changes internally? 
  • How will we support staff through workflow changes, new tech, and new care models – instead of just “dumping another project” on them? 

If your answers are vague, that’s a sign you’re not just “under-documented” – you’re under-decided. 

3. Do we understand what our state is actually prioritizing? 

RHTP is federal, but applications and implementation are state-driven. States submit a Rural Health Transformation Plan to CMS, then design their own program priorities and processes.

Key questions: 

• Do we know our state’s RHTP timeline, NOFO, and stated priorities? 
  • Which populations, service lines, and geographies is your state emphasizing? 
  • Are there specific expectations around behavioral health, maternal health, telehealth, or integration? 

• Do we know how funds will flow in our state? 
  • Will health centers apply directly to the state? 
  • Are there regional hub-and-spoke models or consortia being encouraged? 

• Have we already engaged with our state on the design? 
  • Have we responded to surveys, listening sessions, or RFIs? 
  • Have we clarified how oral health and dental integration fit into the state’s larger strategy? 

If your team is still saying, “We’ll see what the state rolls out and then react,” you’re already behind. Strategically prepared health centers are co-shaping the agenda, not just applying into it. 

4. Are we fixing access with strategy, not just square footage? 

One of RHTP’s core aims is to improve access to care in rural communities, not just keep buildings open.

Before you ask for new space, new chairs, or a new site, ask: 

• Have we maxed out access with the space we already have? 

• Are scheduling templates optimized? 

• At Optimize Practice Alliance, we’ve used scheduling template redesign to help health centers move from the usual 8–13 encounters per provider per day to 50%+ more patient encounters. At Centro Medico, those changes translated into dramatically expanded access with the same number of operatories and staff. 

• Are hygiene, restorative, and medical schedules aligned to minimize bottlenecks? 

• Do we consistently run on time, or do we lose capacity to chaos? 

• Do we have a plan to expand access through better systems, not only more bricks and mortar? 

• Standardized workflows 

• Smarter recall and re-care systems 

• Flexible team-based care models 

• Can we quantify the access lift of our proposed changes? 

• e.g., “With these changes, we can safely increase dental encounters by X% using existing operatories and staff.” 

RHTP reviewers will be looking for transformational leverage, not “more of the same, but more expensive.” 

5. What is our recruitment and retention strategy, beyond “we hope people stay?”  

RHTP explicitly calls out workforce development and retention as a priority.  

So: 

• Do we have clearly defined career pathways and levels for clinical and operational roles? 

• Can an entry-level team member see a path to becoming a lead, manager, or advanced clinical role? 

• How strong is our onboarding and training? 

• Can we reliably take a new grad provider from “brand new” to “highly productive and confident” within a defined timeframe? 

• We also help health centers build structured clinical development pathways so new-grad providers don’t stay “new” for long. Using a combination of simulation-based training, case review, and progressive skill-building, we’ve supported clinicians in going from fresh graduates to confident, efficient providers who can handle advanced procedures with consistency. This kind of structured development doesn’t just improve clinical performance, it strengthens retention and builds long-term workforce stability. 

• Do we understand why people leave us? 

• Are we tracking turnover data and reasons systematically? 

• Do we know where burnout is highest and why? 

• If we used RHTP dollars for workforce, would it be one-time bonuses, or structural change? 

• Training pipelines, professional development, career ladders, and leadership development are far more sustainable uses of funds than short-term pay bumps. 

If your only workforce lever is “pay them more,” you’re leaving a lot of transformation and long-term stability – on the table. 

6. Do we actually have an AI strategy, or just a list of tools we’ve heard about? 

RHTP strongly encourages technology-driven, data-driven solutions that support prevention, chronic disease management, and better outcomes.

For most health centers, that should include an intentional approach to AI. Ask: 

• Who owns AI strategy in our organization? 

• Do we have an AI governance group or at least a designated champion? 

• Do we know what we’re comfortable with and what we’re not? 

• Are we piloting tools that actually free up clinical time and improve quality? 

• Ambient note-taking to give clinicians time back 

• Clinical second-opinion tools (e.g., radiograph analysis, risk scoring, lab decision support) 

• Predictive outreach to identify high-risk patients earlier 

• How will we evaluate AI tools? 

• Impact on access, quality, provider experience, and equity 

• Data privacy and security 

• Alignment with our state’s RHTP priorities 

RHTP is a rare chance to build a responsible AI foundation instead of reacting piecemeal to vendor pitches. Optimize Practice Alliance is leading the charge when it comes to AI in dental care. Our AI rollouts routinely give dentists back 26 minutes a day by wiping out the bulk of their documentation burden. And because our CEO, Josh Gwinn, is the founding president of the Denver chapter of AAIA Global, we’re not guessing at where AI is going, we’re helping shape the standards for safe, effective clinical use. 

7. How ready are we for change management, not just project management? 

Most failed “transformations” don’t die because the idea was bad. They die because nobody planned for the human side. 

Ask: 

• Who is our internal change leader for RHTP? 

• Is there a cross-functional group (medical, dental, behavioral health, operations, finance, IT) that meets regularly? 

• How will we communicate changes to staff and patients? 

• Do we have a plan for training, feedback loops, and iterating without burning people out? 

• What will success look like in year 1, year 3, and year 5? 

• Are we setting realistic milestones – not just “Everything will be transformed by 2030”? 

If your RHTP plan doesn’t have a change-management backbone, the best strategy in the world will stall in the day-to-day. 

8. Can we show sustainability once the grant dollars sunset? 

States and CMS will be looking hard at whether proposed projects will survive beyond the funding window.

Your team should be able to answer: 

• What happens when RHTP funding ends? 

• Does the project collapse, or does it become self-sustaining through improved revenue, cost savings, or other funding streams? 

• Do we have a financial model that ties clinical transformation to financial stability? 

• For example: more completed treatment plans, higher kept-appointment rates, improved coding and documentation, reduced avoidable ED visits. 

• Are we avoiding uses of funds that can’t be maintained? 

• e.g., staffing models that only work if grant dollars are permanent. 

If you can’t show a credible path to sustainability, you’re not fully prepared, no matter how strong your narrative is. 

9. Where are we already strong and who are the right partners for the rest? 

Finally, a simple but important set of questions: 

• What do we already do well that RHTP can help us scale? 

• Maybe it’s a small but successful mobile-based dental program, or an integrated medical-dental workflow in one clinic. 

• Where do we openly need outside expertise? 

• Practice operations and scheduling redesign 

• Our Practice Optimization Process^tm is a strategic, proven framework with a track record of transforming underperforming clinics into high-efficiency, high-access care teams. It’s the same system we’ve used to redesign workflows, tighten scheduling templates, and unlock dramatic gains in patient encounters, without adding staff or operatories. 

• Dental and medical-dental integration 

• We help health centers stand up fully integrated medical–dental care models that bring preventive dental evaluations directly into primary care: no extra chairs, no added complexity. This integrated approach consistently uncovers hidden oral-health needs, drives earlier intervention, and opens entirely new access points inside the existing footprint. It’s one of the fastest, most sustainable ways to expand care without expanding your building. 

• AI governance and clinical second-opinion tools 

• Workforce pathways and training 

• Who are we going to call in before we write the proposal? 

• Implementation partners should be at the design table, not just in the budget appendix. 

Optimize Practice Alliance works with FQHCs and community health centers across the country on exactly these questions, from building sustainable dental programs and integrated care models to designing AI-enabled, clinician-friendly workflows. RHTP is new, but the fundamentals of transformation are not. 

Ready to get serious about RHTP readiness? 

If reading this raised more questions than answers, that’s a good sign. It means you’re thinking at the right level. 

Here’s a simple next step: 

Pull this list of questions into your next leadership meeting.  Have your team rate each area (Sustainable Access, Workforce, Innovative Care, Tech & AI, Change Management, Sustainability) as: 

• We’re clear and ready 
• We’ve started, but it’s shaky 
• We haven’t really tackled this yet 

If you’re not sure where you stand, you’re not alone and you don’t have to figure it out solo. 

Want a working session instead of another webinar? 
OPA can facilitate an RHTP Readiness call tailored to your health center, mapping your current state, clarifying your vision in each pillar, and translating that into fundable, implementable strategies. 

Because the real question isn’t “Can we get the money?” 
It’s “Are we ready to transform our health center once we do?”

Let’s make sure you’re ready before the next bend in the road. Schedule a call today.