Florida home health agencies — particularly those serving rural and medically underserved communities — have a significant opportunity to engage in the state’s new Rural Health Transformation Program (RHTP), a $50 billion, five-year federal initiative designed to modernize care delivery, strengthen the workforce, and expand access to services close to home.

Administered by the Centers for Medicare & Medicaid Services (CMS) and implemented in Florida by the Agency for Health Care Administration (AHCA), the program was created under Section 71401 of the One Big Beautiful Bill Act, signed into law on July 4, 2025. The program is intended to offset projected Medicaid revenue losses tied to changes in State Directed Payments while driving long-term improvements in rural health outcomes.

Why the RHTP Matters to Home Health Providers

AHCA’s vision for the RHTP is a resilient, modern rural health system where residents can access high-quality care close to home. While hospitals and clinics play a central role, many of the program’s initiatives directly align with services home health agencies already provide — or are well-positioned to expand — particularly in care coordination, chronic disease management, post-acute care, workforce development, and technology-enabled care delivery.

For home health agencies, the RHTP represents an opportunity to:

• Expand in-home and community-based care models
• Strengthen partnerships with rural hospitals, EMS providers, and primary care clinics
• Invest in remote monitoring and care coordination technology
• Participate in workforce training and retention initiatives
• Demonstrate value in value-based and outcomes-focused care models

Key Initiatives Relevant to Home Health Agencies

Several of the program’s 15 targeted initiatives are particularly relevant to home health agencies and may support agency-led projects or collaborative partnerships:

Community Paramedicine ($18 Million)

Supports in-home care, post-discharge follow-up, and chronic disease management delivered by emergency medical services (EMS) teams. Home health agencies may partner with EMS providers to coordinate care transitions, reduce readmissions, and support recovery at home.

Remote Patient Telemonitoring ($14 Million)

Funds home-based monitoring devices and AI-supported tools for conditions such as hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and heart failure — core service areas for many home health agencies. This initiative directly supports early intervention and reduced avoidable hospitalizations.

Mobile Health ($20 Million)

Deploys mobile units to reach hard-to-access rural populations. Home health agencies may serve as clinical partners, referral sources, or follow-up providers for patients identified through mobile screenings and preventive services.

Workforce Development ($10 Million)

Supports training programs, clinical rotations, housing assistance, and recruitment pipelines to strengthen the rural workforce. Home health agencies may participate as training sites, employers, or partners in regional workforce strategies.

Value-Based Purchasing ($10 Million)

Helps rural providers transition toward quality-based payment and shared-savings models. Agencies with strong outcomes, care coordination capabilities, and data infrastructure may be well-positioned to participate or partner in these efforts.

Florida Health Information Exchange/Encounter Notification Service Onboarding ($5 Million)

Supports connectivity to Florida’s Health Information Exchange (HIE) and Encounter Notification Service (ENS), enabling real-time admission, discharge, and transfer alerts — critical tools for timely home health referrals and follow-up care.

Important Funding Parameters to Know

Home health agencies considering participation should be aware of several key funding limitations:

• Funds cannot replace billable clinical services; they must fill true coverage gaps or transform care delivery
• Provider payments are capped at 15% of total funding for a project
• No new construction is allowed; renovations must be directly tied to program goals and limited to 20% of funding
• Electronic medical record (EMR) replacements are limited to 5% if a certified system already exists
• Technology “catalyst” projects are capped at 10% of funding or $20 million (whichever is lower)
• Funds cannot be used for clinician wages if the organization uses non-compete contracts

Understanding these guardrails early will be critical as agencies consider project design and partnerships.

How Home Health Agencies Can Get Involved Now

AHCA has emphasized that stakeholder input is essential, and the agency is actively seeking feedback from providers as the program moves forward. Key upcoming milestones include:

• December: Informational town halls (in-person and virtual; click here to download the slide deck)
• January: Procurement postings released
• March: Notice of awards issued

Home health agencies should begin:

• Identifying rural service areas where they operate or plan to expand
• Exploring partnerships with hospitals, EMS providers, clinics, and behavioral health organizations
• Assessing readiness for remote monitoring, data exchange, and value-based care initiatives
• Monitoring AHCA communications for procurement and application details

Bottom Line

The RHTP presents a meaningful opportunity for home health agencies to expand their role in rural care delivery, strengthen partnerships, and invest in innovative models that align with the future of Medicaid and value-based care in Florida. Providers that engage early, collaborate strategically, and align projects with AHCA’s priorities will be best positioned to participate as this major initiative unfolds.