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$195.1M
Year 1 RHTP award (almost 2x expected)
Deliver Vermont RHTP programs with a FHIR-native platform built for Mobile Integrated Health and Specialty Telehealth initiatives. Enable interoperable care coordination, telehealth, remote patient monitoring, and clinical data exchange across rural providers while improving specialty care access and supporting statewide rural
Year 1 RHTP award (almost 2x expected)
For Post-discharge + Sud Care
Behavioral health focus (NASHP)
By Population Share
Mapped To Vermont Rural Health Workflows
US Healthcare Technology Delivery
Vermont received $195.1 million in Year 1 Rural Health Transformation Program funding, nearly double the expected allocation (CMS awards December 2025). The Agency of Human Services (AHS) leads the program, with the Department of Disabilities, Aging, and Independent Living (DAIL) leading specific grants. The plan names telehealth for specialty care access, mobile health teams, primary care incentives, Mobile Integrated Health (MIH) for post-discharge and substance use disorder care, technology upgrades for rural health systems, and a strong behavioral health focus per NASHP analysis. Vermont is the most rural state in the nation by population share, meaning the RHTP impacts a disproportionate percentage of all residents. Vendor procurement opens Q3 2026 through Q1 2027. Mindbowser builds FHIR-native technology for Vermont rural health systems and the AHS RHTP program scope.
Vermont AHS received $195.1 million in Year 1 RHTP funding, nearly twice what was projected. For the most rural state in the nation by population share, this translates to an exceptionally high per-capita investment in rural health transformation. DAIL leads specific grants under the broader AHS program structure.
Vermont’s rural health context:
The nearly-double allocation reflects both Vermont’s rural population concentration and the scope of transformation the state plan proposed across care delivery, behavioral health, workforce, and technology.
What does AI-first care delivery look like for rural hospitals, clinics, and lean care teams?
In this replay, Dr. Shah Khan, Founder & CEO of EnlightenMed, joins Ayush Jain, Founder & CEO of Mindbowser, to discuss how AI-first EHR workflows can support rural providers across access, documentation, RPM, follow-up, and care coordination.
Points Covered In this replay:
Vermont is the only state in the US operating an All-Payer ACO Model. OneCare Vermont, the state's single ACO, unifies Medicare, Medicaid, and commercial insurers under one value-based payment framework. This means Vermont's 8 CAHs already operate under population-based payments, not fee-for-service. The interoperability requirement is therefore different from other RHTP states: FHIR integration must support value-based care data flows (quality measures, total cost of care reporting, population health dashboards), not just clinical exchange. MEDITECH has historically dominated Vermont's smaller hospitals. Epic is expanding through UVM Health Network, the largest system. Several CAHs are on MEDITECH Expanse. Athenahealth serves primary care and community health center settings. VITL (Vermont Information Technology Leaders) is the state HIE. OneCare Vermont's ACO creates interoperability pressure across all vendors because every provider, regardless of EHR, must report into the same value-based framework.
• USCDI v3 became the certification baseline on January 1, 2026. Health IT developers had to update by December 31, 2025, with enforcement discretion through February 28, 2026.
• OneCare Vermont ACO data exchange supporting quality measures, total cost of care reporting, and population health dashboards
• MEDITECH-to-Epic bidirectional exchange for CAH-to-UVM referral workflows
• OAuth 2.0 + SMART on FHIR + identity provider federation
• VITL HIE governance alignment
• MIH platform integration for post-discharge and substance use disorder care coordination
• OneCare Vermont ACO data exchange architecture supporting quality measures, total cost of care (TCOC), and population health reporting
• VITL HIE governance alignment
• MIH platform architecture for post-discharge care coordination and substance use disorder care workflows
• Vermont Medicaid billing configuration for an expansion state where Medicaid covers a significant share of the rural population
• AHS/DAIL RHTP reporting infrastructure
Vermont's broadband challenge is unique: the state committed $229M to broadband buildout ($93M BEAD plus state funds), but the broadband construction workforce shrank 12% from 2018 to 2022. Vermont needs 750 additional broadband construction workers just to execute the buildout plan. The state addressed this through Communications Union Districts (CUDs), a community-driven fiber model unique to Vermont where towns band together to build and own their own fiber networks. CUDs represent a decentralized approach to broadband that no other RHTP state has replicated. Vermont's 8 CAHs already operate under population-based payments through OneCare Vermont's all-payer ACO. This means RPM and telehealth deployments can be financially sustained through value-based reimbursement rather than fee-for-service billing, a structural advantage for long-term technology ROI.
Remote monitoring for chronic disease management where OneCare Vermont's population-based payment model creates financial incentive for prevention over treatment. Integration with MEDITECH and Epic EHRs at 8 CAHs. CUD-built fiber networks provide broadband backbone in participating towns.
The CMS AHCAH waiver extended through September 30, 2030 under PL 119-75 Section 6210 creates the federal framework. Vermont's MIH program extends beyond traditional Hospital at Home into post-discharge care coordination and SUD care management, using mobile teams to bridge discharge-to-recovery. Under OneCare Vermont's all-payer model, readmission reduction directly improves population health metrics and financial performance.
Vermont Medicaid (expansion state, 2014) covers telehealth at parity including audio-only and RPM. OneCare Vermont's all-payer model means telehealth visits count equally toward quality and cost metrics across Medicare, Medicaid, and commercial payers. Behavioral health telehealth is critical given NASHP's identification of behavioral health as a central Vermont RHTP theme.
Vermont is 370 FTE primary care physicians short of its 2030 need: 112 family medicine, 190 internal medicine, and 52 OBGYNs. Five Rural Service Areas have pending HPSA designations. Approximately $6M in HRSA FY2025 rural workforce funding flows to Vermont-specific programs. For the most rural state by population share, this shortage directly impacts the majority of residents. The all-payer ACO model changes workforce economics. Under OneCare Vermont's population-based payments, primary care physicians are not reimbursed per visit but per attributed population. This shifts the value proposition for rural practice: predictable revenue, less administrative billing burden, and financial reward for prevention. Technology platforms that support this model (panel management, population health dashboards, risk stratification) become workforce retention tools. Vermont grants full practice authority to NPs, enabling NP-led rural clinics without physician supervision.
• Primary care incentive tracking under OneCare Vermont’s population-based payment model
• Virtual training platform infrastructure for rural continuing education
• AI-assisted clinical documentation reducing burden on the primary care workforce facing a 370-FTE shortage
• Population health dashboard and panel management platforms supporting value-based practice
Vermont full NP practice authority workflow integration, OneCare Vermont population-based payment workforce tools, CME/CEU credentialing for rural providers, primary care incentive program infrastructure, behavioral health workforce training for NASHP-identified priority areas.
Utah structured its RHTP into 7 named initiatives (PATH, RISE, SHIFT, FAST, LIFT, SUPPORT, LINCS) — the most granular of any state. See how Utah's scope compares across all 50 states.
Vermont follows the common RHTP six-phase procurement timeline. AHS is in Phase 0 activity (setup, stakeholder coordination, procurement development) through Q3 2026. Phase 1 vendor procurement opens Q3 2026 through Q1 2027. Many states require a local entity (hospital, RHC, FQHC, rural health association) as the lead applicant for RHTP funds. In Vermont, OneCare Vermont’s ACO structure means the ACO itself may function as a coordinating entity for technology procurement across participating providers.
For Broader RHTP Technology Planning Across States, Explore Our Rural Health Technology Partner
Agency of Human Services runs the RHTP program, with DAIL leading specific grants. Vendors register through Vermont's state procurement system (BGS Purchasing and Contracting) and respond to AHS-posted RFPs. MIH and specialty telehealth scope may be procured as distinct work packages.
OneCare Vermont's all-payer ACO includes the majority of Vermont's hospitals and providers. Technology that supports population-based payment workflows (panel management, quality reporting, TCOC dashboards) may be procured through OneCare's technology governance rather than state procurement. This is a pathway unique to Vermont.
Vermont Association of Hospitals and Health Systems (VAHHS, coordinating across 8 CAHs), Bi-State Primary Care Association (Vermont and New Hampshire), VITL (state HIE), and Green Mountain Care Board provide the local-entity partnerships and governance alignment required for RHTP technology deployment.
30-minute scope conversations available weekly. Bring your AHS/DAIL contact, VAHHS membership context, or prime contractor scope; we will map capability fit, accelerator alignment, and Vermont-specific procurement pathway in real time.
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Vermont received $195.1 million in Year 1 RHTP funding (CMS award December 2025), nearly double the expected allocation. AHS leads the program covering 8 CAHs, 10 RHCs, and 60+ FQHC sites. Vermont is the only state in the US operating an all-payer ACO model through OneCare Vermont, meaning rural hospitals already receive population-based payments. The plan names specialty telehealth, Mobile Integrated Health for post-discharge and SUD care, mobile health teams, primary care incentives, and technology upgrades. As the most rural state by population share, this investment impacts the majority of Vermont residents.
AHS is in Phase 0 through Q3 2026. Phase 1 vendor procurement opens Q3 2026 through Q1 2027 via Vermont's state procurement system (BGS Purchasing and Contracting). OneCare Vermont's ACO may coordinate technology procurement for participating providers. MIH and specialty telehealth scope may be procured as distinct work packages. Local entities serve as lead applicants, with technology vendors partnering under their applications.
Vermont's OneCare Vermont ACO unifies Medicare, Medicaid, and commercial payers under population-based payment. This means RPM and telehealth are financially sustainable through value-based reimbursement, not fee-for-service billing. FHIR integration must support quality measure reporting, total cost of care dashboards, and population health data flows across all payers. No other RHTP state operates under this payment model.
Vermont committed $229M to broadband buildout, but the broadband construction workforce shrank 12% from 2018-2022. The state needs 750 additional broadband workers. CUDs (Communications Union Districts), a community-owned fiber model unique to Vermont, are closing the gap. On the clinical side, Vermont is 370 FTE primary care physicians short of its 2030 need, with 5 Rural Service Areas pending HPSA designation.
At the BRI Network's 2026 Rural Health Summit, Mindbowser explored the future of rural healthcare through AI and sustainable care models.
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