ACOs · Measurement & Outcomes · 5 min read
What outcomes should accountable care organizations (ACOs) measure for RHTP funding?
RHTP rewards measurable improvement, so accountable care organizations (ACOs) should track total cost of care for attributed rural members, avoidable admissions and readmissions, annual wellness visit and gap-closure rates, and risk-adjusted utilization. Building these metrics in from the start is what separates a fundable, renewable program from a one-time pilot.
Why measurement is non-negotiable
CMS built measurability into the allowable uses, so states pass that expectation to sub-recipients. For accountable care organizations (ACOs), a credible measurement plan is part of the eligibility story, not an afterthought.
Metrics that matter
The most defensible metrics for accountable care organizations (ACOs) include:
- total cost of care for attributed rural members
- avoidable admissions and readmissions
- annual wellness visit and gap-closure rates
- risk-adjusted utilization
Turning metrics into renewals
With $10 billion flowing each year through FY2030, programs that report clean outcome data are best positioned for continued state support. Treating RHTP as grant revenue rather than as fuel for the risk model leaves savings on the table when the funding ends.
Frequently asked questions
- Does RHTP require accountable care organizations (ACOs) to report outcomes?
- States are accountable to CMS for outcomes and pass reporting expectations to their sub-recipients, so yes, in practice.
- How soon should measurement start?
- From day one. Retrofitting measurement after launch weakens both the funding case and the results.
Figures reflect the CMS Rural Health Transformation Program NOFO and the December 2025 award announcement. RHTP Tracker is an independent resource by Moodr Health and is not affiliated with CMS.