Managed Care Organizations · Implementation · 5 min read
How can managed care organizations (MCOs) sustain RHTP-funded programs after 2030?
RHTP funds only through FY2030, so managed care organizations (MCOs) should design for sustainability from the start, building reimbursable models, demonstrating savings, and embedding programs into ongoing operations rather than treating the grant as permanent.
The cliff to plan around
$50 billion flows over five federal fiscal years (FY2026–FY2030), then stops. Misalignment between RHTP-funded services and the plan's value-based incentives can create duplicate or stranded programs.
Sustainability levers
For managed care organizations (MCOs), durable models usually rely on:
- Tying the program to reimbursable services or value-based contracts
- Proving savings or quality gains via HEDIS quality measures for rural members
- Embedding the work in core operations, not a separate grant team
- Lining up co-investment or bridge funding before the cliff
Frequently asked questions
- When should sustainability planning start?
- At design time. Programs built only for the grant period rarely survive the funding cliff.
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.