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FOR IMMEDIATE RELEASE: April 7, 2026
CONTACT: Baylee.Watts@dss.mo.gov
CMS Approves $216 Million Year 1 Budget to Stabilize and Transform Rural Health Care in Missouri
JEFFERSON CITY, Mo. — The Missouri Department of Social Services (DSS) today announced that the Centers for Medicare & Medicaid Services (CMS) has approved $216 million in Year 1 (through September 30, 2027) funding for the state’s Rural Health Transformation Program (RHTP), marking a major step forward in strengthening and stabilizing rural health care across the state. The funding launches full implementation of Transformation of Rural Community Health (ToRCH) Care – Missouri’s statewide transformation strategy.
“Today marks a historic step forward for rural Missouri,” said DSS Director Jess Bax. “With CMS approval secured, these funds will allow Missouri to build a stronger, more connected rural health system that improves outcomes while ensuring long-term sustainability for our providers and communities.”
“Every Missourian should have access to quality health care close to home,” said Governor Mike Kehoe. “We appreciate CMS and our federal partners in approving this transformative funding. This investment reflects Missouri’s commitment to our rural communities and our responsibility to ensure public dollars are used wisely to strengthen local health care and improve long-term stability.”
Strategic Investment Across Five Pillars
CMS-approved Year 1 funding allows Missouri to immediately activate ToRCH Care across five pillars designed to stabilize providers, launch regional networks, modernize digital infrastructure, and lay the groundwork for long-term sustainability.
Pillar 1: Activating Regional Networks & Local Hubs ($52 Million)
- As the operational backbone of ToRCH Care, this funding integrates local providers into a unified system through staffing for local community hubs and supported by a regional coordinating network structure.
- Locally tailored access and care programs
- Partnerships with community-based organizations
These networks will integrate hospitals, FQHCs, behavioral health providers, EMS, pharmacies, and public health agencies into coordinated regional systems. By establishing shared referral pathways and governance structures in Year 1, Missouri will begin replacing fragmented services with an aligned, community-driven care model.
Pillar 2: Advancing Sustainability Through Payment Reform ($9 Million)
Funding initiates the transition toward performance-based reimbursement models that prioritize patient health and lower total costs of care. These investments lay the technical groundwork for long-term financial sustainability, ensuring rural providers can transition from volume-based reimbursement to performance-based models over time.
Pillar 3: Laying the Digital Foundation for Long-Term Transformation ($56 Million)
Missouri is investing $56 million to build a "digital backbone" that connects rural providers through secure, shared data systems. These foundational technology upgrades enable real-time care coordination and pave the way for expanded telehealth and remote patient monitoring - ensuring rural Missourians receive modern, high-tech care regardless of their zip code.
Pillar 4: Expanding and Retaining Rural Health Workforce ($18 Million)
Year 1 funding invests Missouri’s rural healthcare workforce pipeline and improving retention across critical roles. Investments include:
- Expanding EMS training, certification programs, and regional coordination to stabilize emergency care and patient support in rural communities
- Supporting early pipeline programs, including rural high school and community college healthcare pathways
- Supporting retention efforts through childcare, housing, transportation, and preceptor incentives that reduce barriers to rural practice
- Expanding maternal health workforce programs, including doula training, home visiting staff, and development of Missouri’s first Certified Nurse Midwife (CNM) training pathway
- Expanding rural clinical training through medical clerkships and hospital partnerships to improve long-term physician retention
These investments address workforce shortages by building a sustainable pipeline, enabling providers to practice at the top of their license, and improving retention in high-need rural communities.
Pillar 5: Strengthening Rural Providers and modernizing service delivery ($57 Million)
Year 1 funding advances Missouri’s Provider Transformation efforts by stabilizing rural hospitals and modernizing care delivery through targeted investments in infrastructure, technology, and service lines.
Investments include $42 Million across two areas:
- Critical infrastructure repair, safety compliance, and essential equipment replacement to preserve core services in financially vulnerable facilities
- Service line modernization and strategic growth, including expansion of maternal health, behavioral health, and outpatient capabilities (subject to program caps)
Year 1 efforts also advance technology-enabled care by deploying remote patient monitoring (RPM) and ambient AI tools designed to reduce administrative burden and enable proactive, technology-enabled care. Providers are further supported in transitioning to value-based care through participation in alternative payment models and performance-based incentives.
MO Rural Health Transformation Program near-term steps
With CMS approval secured, DSS and the Rural Health Transformation Office (RHTO) are moving from planning to execution. Year 1 will focus on establishing the systems, partnerships, and infrastructure needed to activate ToRCH Care statewide. Key actions include:
- Launching statewide town halls and webinars to communicate the program’s vision, structure, and expected impact
- Issuing competitive procurement opportunities to support core infrastructure, including digital backbone, interoperability, and workforce development
- Establishing standardized governance, onboarding, and performance processes to ensure consistency and accountability across all regions
- Analyzing the Digital Readiness Survey to assess electronic health record (EHR) maturity, interoperability capacity, and cybersecurity readiness to guide technology investments and modernization efforts
- Onboarding the first community Hub cohort, including leadership structure, staffing, and referral workflow integration
A Long-Term Commitment to Rural Missouri
The Rural Health Transformation Program brings together hospitals, clinics, community-based organizations, and local leaders to develop sustainable solutions tailored to the unique needs of Missouri’s rural communities.
Developed through a collaborative process recognizing Missouri’s innovation, community engagement, and measurable impact, the state’s transformative plan was crafted in coordination with the Governor’s Office, DSS, the Department of Health and Senior Services, the Department of Mental Health, and many healthcare partners and stakeholders.
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The Rural Health Transformation Program information provided by the Missouri Department of Social Services is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $216,276,817.66, with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CMS/HHS, or the U.S. Government.
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