Missouri’s implementation of the federal Rural Health Transformation Program (RHTP) is anchored by ToRCH Care (Transformation of Rural Community Health), the state’s hub-and-spoke Medicaid delivery initiative designed to help rural hospitals function as regional community care hubs. The RHTP is a landmark $50 billion federal investment designed to reshape healthcare in rural communities across America. Coordinated by the Missouri Department of Social Services (DSS), the state secured $216 million of federal funding in Year 1 to help stabilize rural hospitals, modernize technology, and improve community-based care coordination.
Missouri’s RHTP is premised on five core pillars – Regional Coordination of Networks and Hub Activation; Provider Transformation; Digital Backbone; Rural Health Workforce; and Alternative Payment Models. Year 1 funding, which will focus on implementation of these core pillars, must be committed by October 2026 and spent by October 2027. The state must also submit its Year 2 proposed budget, based on its receipt of $216 million in Year 1, by the end of August.
As reported by Joe Miller, Director of the state’s RHTP, on August 12, 2026, approximately $130 million of funds have been committed over three agreements, with many funds going to updating existing infrastructure. This includes $32 million for capital improvements of rural hospitals, $40 million to rural facilities to improve three service lines (maternal health, behavioral health, and outpatient and chronic disease management), and $13 million to broaden rural workforce.
Missouri has further completed its selection of its twenty-seven hub anchors as of mid-July. These hub anchors, modeled after the aforementioned ToRCH pilot, will provide regional coordination for closed-loop, integrated patient care, including local provider coordination of behavioral health, pharmacies, and public agencies.
To ensure local engagement and smooth onboarding, DSS has been holding statewide ToRCH Care Roadshows to connect with hospital leaders, local health departments, and regional partners. Launched in May and June, these Roadshows, a series of 12 in-person sessions, engaged rural healthcare providers, community organizations, and partners to strengthen collaboration and support improved access to care across Missouri.
In the near term, as Year 1 commitments become due and Year 2 priorities emerge, the state’s RHTP is expected to focus on build-out of a technology platform(s) that can coordinate and integrate multiple existing electronic health records (EMRs) into a centralized mechanism.
For direct program guidance, funding opportunity updates, and to connect with the state’s Rural Health Transformation Office, visit the Missouri Department of Social Services portal.
The RHTP website (https://mydss.mo.gov/mhd/rural-health)