Eligibility and Application Process

Program Eligibility

Eligible Rural Healthcare Provider Transition Project (RHPTP) applicants include small rural hospitals and Centers for Medicare and Medicaid Services (CMS)-certified rural health clinics.

Hospitals must meet all three eligibility requirements listed below; clinics must only meet the “rural area” requirement listed below.

  1. "Eligible small rural hospital" is defined as a non-federal, short-term general acute care hospital that: (1) is located in a rural area as defined in 42 U.S.C. 1395ww(d) and (2) has 49 available beds or less, as reported on the hospital's most recently filed Medicare Cost Report.
  2. "Rural area" is defined as either: (1) located outside of a Metropolitan Statistical Area (MSA); (2) located within a rural census tract of a MSA, as determined under the Goldsmith Modification or the Rural Urban Commuting Areas; or (3) is being treated as if being located in a rural area pursuant to 42 U.S.C. 1395ww (d)(8)(E).
  3. Eligible hospitals may be for-profit or not-for-profit, including faith-based. Hospitals in U.S. territories as well as tribally operated hospitals under Titles I and V of P.L. 93-638 are eligible to the extent that such hospitals meet the above criteria.

In addition, applicant organizations:

  • Must not be a current participant in an advanced alternative payment model (Advanced APM) as defined by CMS, or the Community Health Access and Rural Transformation (CHART) Model.
  • Must be financially stable. Applicants should consider their past and present performance as compared to national benchmarks on key performance indicators (days cash on hand, total margin, operating margin, patient revenue, days in net accounts receivable, payor mix, etc.) as well as non-measurable variables such as leadership stability and succession planning for retiring primary care providers. (Applicants can use resources like CAHMPAS and the Small Rural Hospital and Clinic Finance 101 guide to help determine financial stability.)
  • Must be interested in and motivated to becoming part of an APM.
  • Must, if a small rural hospital, be meeting the quality data reporting requirements of Inpatient Quality Reporting, Outpatient Quality Reporting or the Medicare Beneficiary Quality Improvement Project.
  • Must not be a current participant in the Delta Region Community Health Systems Development Program, the Vulnerable Rural Hospital Project, the Small Rural Hospital Transition Project, or any other program that is duplicative in services.

Application Process

Online applications for RHPTP are accepted on a rolling basis; however, an annual application deadline — typically in September — is announced each project year. (Once the application deadline has passed, organizations may begin applying for participation in the next project year.)

Applications can be made by individual health care organizations (critical access hospitals, small rural hospitals, rural health clinics), jointly by a hospital and a rural health clinic or clinics, or by a consortium of rural health clinics.

Each submitted application is followed by a one-hour phone interview with members of the RHPTP team.

Organizations selected to participate in the upcoming project year will be notified by phone and email by late October or early November. Program activities begin in January.

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