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Measuring outcomes under CMS’s Rural Health Transformation Program

From program design to impact: The importance of performance measurement in RHTP

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The Centers for Medicare & Medicaid Services' (CMS) Rural Health Transformation Program (RHTP) was established to address the challenges rural communities across the US face accessing timely, high‑quality health care. Designed as a cooperative agreement with states, the program emphasizes steady, measurable progress across a five-year period.

Continued funding is explicitly linked to ongoing performance and compliance. Performance monitoring and reporting are continuous requirements throughout the grant period. Treating performance tracking as an ongoing management function rather than a reporting obligation can help position states to demonstrate progress, respond to CMS inquiries, support continued funding across budget periods, and reinforce program value to the communities they serve.

In this paper, we discuss the RHTP reporting and compliance requirements, and lay out a structured approach that can help states meet those requirements and embed performance management into RHTP execution to maintain momentum for long-term rural health transformation.

Dive into our thinking:

Measuring outcomes under CMS’s Rural Health Transformation Program

While compliance with program-specific requirements is essential, a truly effective measurement framework must also capture the long-term, holistic value that programs deliver to communities. This philosophy is built on the understanding that improving rural health is not only a clinical priority but also a strategic economic investment.

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Strength beyond the metrics

The KPMG holistic, data-driven approach can provide states with three key benefits:

1

It turns compliance into continuous performance management, helping states stay funding-ready and better positioned for annual CMS continuation reviews.

2

It creates a single source of truth for performance data, improving reporting consistency, data quality, and visibility across initiatives, vendors, and subrecipients.

3

It measures long-term health and economic impact, not just program activities, enabling leaders to demonstrate lasting value, ROI, and community outcomes.

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