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Rural Health Innovation and Transformation Technical Assistance

Grants to USA Nonprofits, Tribes, and Agencies to Develop and
Implement Value-Based Health Care in Rural Areas

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US Department of Health and Human Services, Health Resources and Services Administration (HRSA) - Federal Office of Rural Health Policy (FORHP)

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Grants to USA nonprofit organizations, tribes, tribal organizations, public organizations, and faith-based organizations to develop and implement value-based health care initiatives in rural areas. Applicants are advised that required registrations may take up to one month to complete. The purpose of this program is to provide technical assistance (TA) to rural stakeholders and the public to help them understand and engage in the value-based care landscape in the context of rural health care.

In an effort to control health care costs and improve the quality of care, public and private payers have increasingly implemented initiatives to encourage value-based care. Value-based care programs reward health care providers for the quality of care through the realignment of financial incentives towards value over volume. Because of the unique economic factors affecting rural providers, the implementation and effects of value-based care initiatives may look different in rural, low-volume settings. For example, low patient volumes, along with low margins, in rural settings can make it more difficult to absorb the financial risks associated with value-based care. Start-up costs for value-based care may seem prohibitive for some, while small volumes may make it more difficult to measure value and may increase the risk of skewed outcomes. At the same time, value-based care initiatives are evolving towards risk-based models, and there is a need to help stakeholders and the public understand how these changes affect rural health care. Therefore, a major goal of this funding opportunity is to support the ability of rural providers to participate and succeed in current and emerging payment and delivery system models designed to provide value-based care.

Value-based care is one of the four priorities of the United States Department of Health and Human Services (HHS). Through the prioritization of value-based care, HHS is working to transform our healthcare system from one that pays for procedures and sickness to one that pays for outcomes and health, focusing on four areas:

1. Maximizing the promise of health information technology (IT), including through promoting interoperability.
2. Boosting transparency around price and quality.
3. Pioneering bold new models in Medicare and Medicaid.
4. Removing government burdens and barriers, especially those impeding care coordination.

In 2018, the Centers for Medicare & Medicaid Services (CMS) issued its CMS Rural Health Strategy to elevate rural health as an important focus of its provider payment policies, including delivery system reform and innovation opportunities. In alignment with the HHS priorities and the CMS Rural Health Strategy, this funding opportunity seeks to provide a mechanism for the federal government to work collaboratively with rural health care stakeholders on TA to achieve the following goals:

1. Raise awareness of the unique considerations facing rural providers and communities in implementing value-based care in the current and emerging environments, with a particular focus on the four strategic areas identified above.
2. Engage stakeholders with strategies to help rural providers and communities participate in value-based care models.

Types of applications sought: New, Competing Continuation HRSA will provide funding in the form of a cooperative agreement. A cooperative agreement is a financial assistance mechanism where substantial involvement is anticipated between HRSA and the recipient during performance of the contemplated project.

HRSA Program involvement will include:

- Collaborating in the planning and development of the TA portfolio and of key areas of focus;
- Reviewing and providing input on activities and any findings or information generated under this award prior to public dissemination;
- Participating in the planning and implementation of any meetings or other working groups convened during the period of performance; and
- Consulting on dissemination strategies for delivering TA to varied audiences interested in rural health care delivery innovations.

The cooperative agreement recipient’s responsibilities will include:

- Identifying key rural health policy issues and challenges related to value-based care to inform and engage rural health stakeholders;
- Participating in the planning and development of the work portfolio and the final selection of focus areas;
- Developing and providing TA on value-based care in rural settings and synthesizing the results into materials for public dissemination;
- Submitting materials for HRSA review and input and responding to requests for information from HRSA in a timely manner; and
- Designing and implementing dissemination strategies for analyses and TA to varied audiences interested in rural health care delivery innovations.

GrantWatch ID#:

GrantWatch ID#: 184839

Estimated Total Program Funding:


Number of Grants:

Expected Number of Awards: 1

Estimated Size of Grant:

Up to $500,000 per year subject to the availability of appropriated funds

Term of Contract:

The period of performance is August 1, 2019 through July 31, 2022 (3 years).

Funding beyond the first year is subject to the availability of appropriated funds for RHIT-TA in subsequent fiscal years, satisfactory recipient performance, and a decision that continued funding is in the best interest of the Federal Government.

Additional Eligibility Criteria:

Eligible applicants include domestic public, private, and non-profit organizations, including tribes and tribal organizations, and domestic faith-based and community-based organizations.

Pre-proposal Conference:

HRSA has scheduled the following technical assistance:

Day and Date: Wednesday, December 19, 2018
Time: 3 – 4 p.m. ET
Call-In Number: 1-800-369-3168
Participant Code: 3587084
Playback Number: 1-866-441-8828
Passcode: 7648

Pre-Application Information:

The due date for applications under this NOFO is February 22, 2019 at 11:59 p.m. Eastern Time. HRSA suggests submitting applications to at least 3 days before the deadline to allow for any unforeseen circumstances.

HRSA anticipates issuing/announcing awards prior to the start date of August 1, 2019.

Ensure your and registrations and passwords are current immediately! HRSA will not approve deadline extensions for lack of registration. Registration in all systems, including and, may take up to 1 month to complete.

HRSA may not make an award to an applicant until the applicant has complied with all applicable DUNS and SAM requirements and, if an applicant has not fully complied with the requirements by the time HRSA is ready to make an award, HRSA may determine that the applicant is not qualified to receive an award and use that determination as the basis for making an award to another applicant.

The registration process requires information in three separate systems:
- Dun and Bradstreet (
- System for Award Management (SAM) (
- (

HRSA requires you to apply electronically. HRSA encourages you to apply through using the SF-424 workspace application package associated with this NOFO following the directions provided at

View this opportunity on

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

Benjamin White
Grants Management Specialist
Division of Grants Management Operations, OFAM
Health Resources and Services Administration
5600 Fishers Lane, Mailstop 10SWH03
Rockville, MD 20857
Telephone: (301) 945-9455

Kerri Cornejo
Public Health Analyst, Policy Research Division
Federal Office of Rural Health Policy
Health Resources and Services Administration
5600 Fishers Lane, Room 17N166D
Rockville, MD 20857
Telephone: (301) 443-4204
Email: Contact Center Telephone: 1-800-518-4726 (International Callers, please dial 606-545-5035) Email:

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Geographic Focus:

USA: Alabama;   Alaska;   Arizona;   Arkansas;   California;   Colorado;   Connecticut;   Delaware;   Florida;   Georgia;   Hawaii;   Idaho;   Illinois;   Indiana;   Iowa;   Kansas;   Kentucky;   Louisiana;   Maine;   Maryland;   Massachusetts;   Michigan;   Minnesota;   Mississippi;   Missouri;   Montana;   Nebraska;   Nevada;   New Hampshire;   New Jersey;   New Mexico;   New York City;   New York;   North Carolina;   North Dakota;   Ohio;   Oklahoma;   Oregon;   Pennsylvania;   Rhode Island;   South Carolina;   South Dakota;   Tennessee;   Texas;   Utah;   Vermont;   Virginia;   Washington, DC;   Washington;   West Virginia;   Wisconsin;   Wyoming