Regionalization and Innovative Care Strategies
Moves care into regional and community settings through community paramedicine, mobile medical and dental units, facility upgrades, mental health urgent care and a statewide delivery plan.
RHTP state profile · Vermont
Vermont Rural Health Transformation Program
Vermont received $195.1 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 32nd of 50 states. The Vermont Agency of Human Services (AHS) runs the program, which funds five initiatives across every county except Chittenden, from regional care and shared technology to primary care and workforce.
Year 1 awards, all 50 statesVT: $195.1M
Texas $281.3MNew Jersey $147.3M
$195.1MYear 1 award, 32nd of 50
5Funded initiatives
13 / 14Vermont counties are rural
AHSVermont Agency of Human Services
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
Vermont's program at a glance
The award is fixed for the year. Spending moves every quarter, so Vermont's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Year 1 award$195,053,740, 32nd of 50 states
Run byVermont Agency of Human Services
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives5
Rural counties13 of 14
Spending data through July 31, 2026Vermont's section of the Year One Report →Initiatives
What does Vermont's RHTP fund?
Vermont's RHTP funds five initiatives built on the state's existing health care reform work: regional care, shared services, primary care, workforce and price transparency. Each initiative includes several activities, and every Vermont funding opportunity maps to one of them.
Establishing a Clinically Integrated Network of Shared Services
Shared technology and back-office systems, including a voluntary shared EHR, e-consults, telehealth, remote monitoring, AI scribes and a statewide closed-loop referral system.
Strengthening Primary Care
Team-based primary care payments through the Blueprint for Health, mental health staff in primary care, FQHC access and recovery housing.
Health Care Workforce Development
Licensed nursing assistant training, tuition and scholarships tied to rural service, a family medicine residency and preceptor grants.
Price Transparency and Insurance Competition
Modernizes the statewide health care data platform and studies options to make coverage more affordable, such as reinsurance.
Recipients by initiative are in Vermont's section of the RHTP Year One Report.
Source documents
Vermont's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a Vermont solicitation.
PDFAHSVermont RHT Program Project NarrativeThe full plan from AHS, revised June 29, 2026, including all five initiatives and Vermont's policy commitments.PDFAHSVermont RHT Activity DetailsEvery activity under the five initiatives, updated July 17, 2026.PDFAHSVermont RHT Application SummaryAHS's short overview of the plan.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural county (13)Chittenden County (1)
Eligibility
Which Vermont counties are eligible for RHTP funding?
Vermont treats every county except Chittenden as rural, using the federal Office of Rural Health Policy definition. The plan also names six rural counties of focus: Essex, Orleans, Caledonia, Windham, Bennington and Rutland. Funding is meant to benefit rural areas statewide, and each solicitation states its own geographic requirements.
How to apply
How can Vermont providers apply for RHTP funding?
Vermont providers and vendors apply through AHS grant opportunities (NOFOs) and requests for proposals, posted on its RHT RFPs and NOFOs page. All Year 1 opportunities have closed, and Year 2 dates have not been announced. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the five, and the Activity Details document lists every activity.
- Join the RHT email list.AHS announces Year 2 grant and RFP openings through its RHT listserv and the RFPs and NOFOs page.
- Register as a vendor.State RFPs post on the Vermont Business Registry. SAM.gov registration is standard for federally funded grants and contracts.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year.
- Ask AHS directly.Email ahs.rht@vermont.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Vermont recipient.
Grants and contracts carry different obligations
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can Vermont's RHTP funding pay for?
Vermont's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Vermont's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $39.0M
Provider payments15% of award
About $29.3M
Administrative costs10% of award
About $19.5M
Rural Tech Catalyst Fund10% or $20M, whichever is less
About $19.5M
Replacing an existing EMR system5% of award
About $9.8M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Vermont's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
Vermont's policy commitments carry deadlines
Vermont made several policy commitments in its application. Two are done. CMS can reduce or recover funding if the rest slip.
Pharmacist test-to-treat
Expand pharmacists' authority to test and treat common conditions
H.588 signed June 2026Nurse anesthetist supervision opt-out
Opt out of Medicare's physician supervision requirement for CRNAs
Opt-out letter sent July 2, 2026SNAP food restriction waiver
Seek a USDA waiver limiting non-nutritious SNAP purchases
Not yet submitted to USDA as of spring 2026EMS scope of practice
Expand community paramedicine and treat-in-place care through rules and a payment model
Coverage affordability
Act on options such as reinsurance to make insurance more affordable
Vermont already belongs to the nurse, counseling, psychology, physical therapy, occupational therapy, social work, audiology and speech-language pathology, and dietitian licensure compacts.
Years 2 to 5
$40B
Future awards depend on progress
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading Vermont's spending data
Use the numbers in Vermont's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as Vermont reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search Vermont's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major Vermont announcements
Rutland Regional Medical Center announces $3.15 million in RHT grants for a women's health clinic, pharmacy, AI scribing, telepharmacy and palliative care.
The Vermont Department of Health announces $9 million for VSAC tuition benefits for health care students who commit to five years of rural service.
Vermont withdraws from the CMS AHEAD model and shifts its focus to the Rural Health Transformation Program.
The Legislature's Joint Fiscal Committee accepts the federal grant.
CMS awards Vermont $195.1 million for Year 1.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Feb 6, 2026Joint Fiscal Committee accepts the grant
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Aug 30, 2026Vermont's first annual report to CMS due
- Oct 30, 2026Deadline to obligate Year 1 funds; Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Sep 30, 2027Deadline to spend Year 1 funds
- Dec 31, 2027EMS policy deadline
- Jan 15, 2028Final Statewide Health Care Delivery Plan due
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Vermont's Year 1 money went largely to regionalization, including hospital facility upgrades and transformation grants tied to the state's Act 68 hospital transformation work. Expect Year 2 rounds to follow the regional plans, and watch the Green Mountain Care Board's hospital budget decisions, which shape how much room hospitals have to change.
For partners and vendors
Vermont buys through state RFPs and contracts, from analytics and planning to a closed-loop referral system and data platform work. Telehealth, e-consults, remote monitoring and AI scribes are the most active technology lanes. Year 2 RFPs will post on the AHS page and the Vermont Business Registry.
For applicants and grantees
Build tracking for the measures Vermont reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Vermont's annual rescoring. Year 1 funds must be spent by September 30, 2027.
FAQ
Vermont RHTP FAQs
Who runs Vermont's Rural Health Transformation Program?
The Vermont Agency of Human Services (AHS) runs Vermont's Rural Health Transformation Program through its Office of Health Care Reform, using federal funding from the Centers for Medicare & Medicaid Services (CMS). AHS manages the state's plan, posts funding opportunities and answers questions at ahs.rht@vermont.gov. The program is Vermont's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Vermont receive?
Vermont received $195,053,740 for Year 1 of the Rural Health Transformation Program, 32nd of 50 states. Every state got $100 million in baseline funding, and the rest of Vermont's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Vermont's progress.
Can Vermont RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Vermont's award each year, about $39.0 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can Vermont providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to Vermont's plan, up to 15% of the award each year, about $29.3 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Vermont is spending its RHTP funding?
The RHTP Year One Report tracks how much of Vermont's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. AHS also posts its own list of executed Year 1 agreements and contracts, which includes awards made after July 31.
The Alliance
RHT Alliance members serving Vermont
These RHT Alliance members serve Vermont providers, with support that spans virtual nursing, virtual care, remote monitoring, health data, diagnostics, patient education, drone delivery and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
Valkyrie UAS SolutionsLong-range drone delivery of medications, specimens and organs to rural hospitals.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow Vermont's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.