CEO Update: Rural Health Transformation is a roadmap for better local care

CEO Update Community
• 22 September 2026

Michael Calhoun shares the latest happenings at CMH in his monthly CEO Updates. He is the CEO/executive director of CMH and the Citizens Memorial Health Care Foundation.

Healthcare is always changing, and recently there was a significant change for rural healthcare organizations. As part of legislation from House Resolution 1, commonly referred to as the One Big Beautiful Bill, $50 billion in funding is available for rural communities to transform how care is provided. This funding established the Rural Health Transformation Program.

Missouri was awarded $216 million to go toward Rural Health Transformation across the state, and CMH was recently selected as the Hub Anchor for Region 7.

Jenna Hicks is our director of quality and population health. She’s leading our Rural Health Transformation efforts. Continue reading the blog post or watch the video to learn more about Rural Health Transformation as Jenna and I discuss:

• What is Rural Health Transformation?
• Collaboration among healthcare providers
• Hub 7 priorities
• Defining success

What is Rural Health Transformation?

Hicks: Rural Health Transformation funding, while it’s not a replacement for Medicaid cuts, is the largest investment in rural health care ever. Each state then applied through a competitive process for their portion of those funds. Missouri had already been navigating in this space through the Transformation of Rural Community Health Pilot program in which CMH has been participating.

Missouri was awarded the ninth-highest amount out of all 50 states, based on the strength of our plan to transform rural health. In Missouri, half of hospitals are rural, and about half were operating at a financial loss prior to the Medicaid cuts. It’s a really significant opportunity for the state to engage and transform rural health care so it stays sustainable, and that’s been the Centers for Medicare & Medicaid Services’ mission all along.

Collaboration among healthcare providers

Calhoun: One of the things I love about the plan that Missouri put forward, that we’re going to be carrying out and operationalizing, is that it involves working collaboratively with other healthcare providers to be able to meet the needs of the community. I think so often in healthcare, we operate in silos.

We created a hub board that represents several different organizations in our community. I really like the fact that we’re going to be sitting together at the same table, solving the problems, looking at the gaps that we have and creating innovative solutions to make health care better in our communities.

The governance board includes members from:

• CMH
• Ozarks Community Health Center
• Cedar County Memorial Hospital
• Polk County Health Center
• Centerstone
• Local Area Agency on Aging
• Exceptional Pupil Cooperative

Hicks: Collaboratively, the board will review data and discuss current barriers in identifying those priorities and then identifying specific strategies that can be implemented regionally for addressing them. With that proposal, those are shared and elevated to the regional coordinating network and then onward to CMS to review and approve for funding.

Calhoun: The hub that we’re serving is five counties, so we’re representing the needs of all five of those counties.

Hub 7 priorities

Calhoun: The priorities are somewhat laid out for us, but we need to understand where the need is in our communities. We have to decide that. The pillars are really given to us through the Missouri plan:

• Strong collaborations and partnerships
• Rural health workforce
• Shared technology infrastructure
• Transforming healthcare delivery for rural needs
• Pay for value, not pay for volume

In the first year, there are already established priorities for that hub to investigate.

Hicks: Our region has identified that the two greatest priorities for addressing within the first 12 months are behavioral health needs, accessing it outside of the Emergency Room and after the ER, but also transportation. Without transportation, you can’t access the care you need without a lot of technology investments.

Calhoun: Those two priorities are common in really all of the communities that the hub represents.

Defining success

Hicks: I think success would be the freedom to live and work in a community where you have equal access to the benefits of any other community; that how well you live and how long you live isn’t dependent on something as flippant as a ZIP code, based on just access to care in that community, and that we would have healthy communities. To have healthy communities, you have to have access to high-quality health care close to home. Just the sustainability of providing that would be a home run.

Calhoun: When you talk about sustainability, to me, that’s what success will look like. Not just that we’re here, but that we have a model that really fits the needs of our communities that will work in the future.

There’s so much opportunity to improve health care, and we have the right talent to figure out the solutions. It’s important for rural health care organizations to look past the number of dollars we get and ask how we can change how we provide care to ensure it’s sustainable for the future. If we can be starting down that road at the end of the five years, and get a good roadmap for that, I feel like it will be a success.

About RHTP funding

This program is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award authorized under H.R. 1, with 100 percent of the total program costs funded by CMS/HHS and no non-governmental funding. The contents of this presentation are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CMS/HHS or the U.S. Government.