The Year 1 Grant Checks Are Landing. Make Them Last.

1 day ago

3 min read

Updated: 2 hours ago

Rural critical access hospital at sunrise with mountains behind

In the last ten days of October, three states announced where their first year of Rural Health Transformation Program (RHTP) money is going. For a lot of rural hospitals, this is the biggest outside investment they have seen in years.

Wyoming completed Year 1 awards for its $205 million program on October 23. Almost half, 44.8 percent, is aimed at emergency care access, including critical access hospitals and EMS. About 27.5 percent goes to the rural workforce. Roughly $11 million, some of it for maternal health, is still being allocated through the Wyoming Hospital Association. (Governor of Wyoming; Wyoming Public Media)
Idaho completed $186 million in Year 1 awards on October 28 across five initiatives, from technology and new care models to workforce and infrastructure. Benewah Community Hospital alone received about $6.65 million for clinic modernization. (Office of the Governor of Idaho)
Virginia announced nearly $22.7 million on October 30 for remote patient monitoring, new rural residency positions, and Food is Medicine programs. (VHHA Foundation)

Kerry Ashment, CEO of The Memorial Hospital of Carbon County in Wyoming, described emergency services as "the first link in the chain of survival." That is exactly what this money is meant to protect.

The risk picture improved a little. It did not go away.

The same week, the Center for Healthcare Quality and Payment Reform (CHQPR) released its October 28 analysis. It found 698 rural hospitals, about one third of the country's rural hospitals, at risk of closing, and 260 at immediate risk. That is slightly better than CHQPR's spring and summer reports. Rural hospitals are at risk in every state except Utah, Delaware, Maryland, and New Jersey, and in 11 states half or more are at risk. (Medicaid Monitor summary of CHQPR, via Becker's Hospital Review)

The most important line in that analysis is about cause. CHQPR attributes most rural hospital losses to underpayment by private insurers, including employer plans and Medicare Advantage, rather than Medicare or Medicaid. It estimates about $4 billion in additional payments each year could prevent the at-risk closures.

A one-time grant can build a clinic, buy equipment, or fund a residency slot. It does not fix a commercial contract that pays less than the cost of care, and it does not stop a claim from being denied next spring.

Three ways to make a Year 1 award last past Year 5

1. Pair every capital project with a revenue plan. If the grant builds or equips something, write down on day one how that service line will pay for its own staff once the grant ends.

2. Spend some of the effort on what grants cannot buy. Payer contracts, utilization review, clinical documentation, and denial prevention decide whether a hospital keeps the revenue it already earns. Those are the leaks CHQPR is pointing to.

3. Do not do it alone. Several of the largest awards this cycle went to partnerships and networks. Small hospitals that share expertise, training, and buying power stretch every dollar further.

Make the most out of your grant funding with a nonprofit partner

Cornerstone Rural Health Collaborative is a veteran and nurse-led 501(c)(3) built around one goal: Zero Closures. We help rural and critical access hospitals turn grant dollars into lasting stability, from grant-aligned planning to the operational work that keeps services open after the check is spent.

Expert advice, non-profit price. Our partners get critical access hospital friendly pricing and the highest quality standards.

If your hospital received RHTP funding, or is waiting to hear, let's talk about making it last.

Contact Cornerstone