Rural Health Transformation Program

The technology partner behind your RHTP initiative

States committed to specific, scored technology outcomes to win this money. Now someone has to build them, against a spend clock, in places that carry no engineering bench.

Digital Scientists designs and builds the systems that deliver those commitments. NeverAlone is our proof. We built it and we run it, supporting 26,000+ patients across 130+ facilities in 7 states today.

Our proof, running in production today

NeverAlone 26,000+ patients 130+ facilities 7 states 96% treated in place See the proof →
Rural Health Transformation Program Year 1 obligations by stateA tile map of all fifty states, each shaded by its federal fiscal year 2026 obligation under the Rural Health Transformation Program. Every state holds an award. Totals run from $147.3 million in New Jersey to $281.3 million in Texas and sum to exactly $10 billion. Source: USAspending.gov, Assistance Listing 93.798, pulled 16 August 2026.AK: $272.2M obligated for FY2026AKME: $190.0M obligated for FY2026MEVT: $195.1M obligated for FY2026VTNH: $204.0M obligated for FY2026NHWA: $181.3M obligated for FY2026WAID: $186.0M obligated for FY2026IDMT: $233.5M obligated for FY2026MTND: $198.9M obligated for FY2026NDMN: $193.1M obligated for FY2026MNIL: $193.4M obligated for FY2026ILWI: $203.7M obligated for FY2026WIMI: $173.1M obligated for FY2026MINY: $212.1M obligated for FY2026NYRI: $156.2M obligated for FY2026RIMA: $162.0M obligated for FY2026MAOR: $197.3M obligated for FY2026ORNV: $179.9M obligated for FY2026NVWY: $205.0M obligated for FY2026WYSD: $189.5M obligated for FY2026SDIA: $209.0M obligated for FY2026IAIN: $206.9M obligated for FY2026INOH: $202.0M obligated for FY2026OHPA: $193.3M obligated for FY2026PANJ: $147.3M obligated for FY2026NJCT: $154.2M obligated for FY2026CTCA: $233.6M obligated for FY2026CAUT: $195.7M obligated for FY2026UTCO: $200.1M obligated for FY2026CONE: $218.5M obligated for FY2026NEMO: $216.3M obligated for FY2026MOKY: $212.9M obligated for FY2026KYWV: $199.5M obligated for FY2026WVVA: $189.5M obligated for FY2026VAMD: $168.2M obligated for FY2026MDDE: $157.4M obligated for FY2026DEAZ: $167.0M obligated for FY2026AZNM: $211.5M obligated for FY2026NMKS: $221.9M obligated for FY2026KSAR: $208.8M obligated for FY2026ARTN: $206.9M obligated for FY2026TNNC: $213.0M obligated for FY2026NCSC: $200.0M obligated for FY2026SCOK: $223.5M obligated for FY2026OKLA: $208.4M obligated for FY2026LAMS: $205.9M obligated for FY2026MSAL: $203.4M obligated for FY2026ALGA: $218.9M obligated for FY2026GAHI: $188.9M obligated for FY2026HITX: $281.3M obligated for FY2026TXFL: $209.9M obligated for FY2026FLFY2026 OBLIGATION, $M147186197206213–281

All 50 states hold an award. $10 billion obligated for FY2026, from $147M to $281M. Every one of them committed to technology outcomes that someone now has to deliver.

The clock

30 Oct 2026
Year 1 funds must be obligated
31 Oct 2026
FY2027 allocations announced
Every year after
Technical score recalculated
FY2030
Program ends. Funding stops

Start where you actually are

This page is written for people who have to deliver something technical against this money, not for a policy audience. Three situations, three different next steps.

Most common

You hold an award

A hospital, health center, EMS agency or ACO with subaward money and a scope you now have to deliver, probably without an engineering team. The clock matters more than the strategy.

Start with a readiness review →
Highest leverage

You buy on behalf of many

A state office of rural health, hospital association, health information exchange or innovation center serving a group of small awardees. No single award funds a platform. Together they do.

See how the ecosystem works →
Year 2

You are writing the next application

Technical sections get written two to four weeks before a deadline and nobody researches a delivery partner in that window. Alabama publishes Year 2 opportunities in November and December 2026.

Understand the scoring first →
Capabilities

What we build

Six things, all of them in production somewhere today. Each one maps to a factor CMS scores and to an approved use of funds.

Virtual care and treat in place

Provider on demand at the point of care, escalation, documentation, and proof of diversion.

Interoperability and data infrastructure

State HIE connection, identity matching, terminology mapping, EHR integration.

Consumer-facing care technology

Devices and interfaces the people this program funds will actually use.

Clinical AI and documentation

Ambient documentation, assessment support, triage, back-office automation.

Revenue cycle and risk adjustment

Capturing revenue already earned, which is what keeps an initiative alive after 2030.

Multi-tenant platforms

One solution funded once, used by every organization in a region, data isolated per tenant.

The problems

The problems this money has to solve

Your award describes outcomes, not software. These are the problems underneath those outcomes, the CMS factors each one earns against, and what we have already delivered in production against the same problem.

Treatment in place

F.1 · C.2

Patients get moved for conditions that could have been handled where they already are, and every transfer costs the patient, the family and the system.

We build the path from a person at the point of care to a licensed provider in minutes: the device, the provider network credentialed state by state, escalation and hand-off, documentation that survives an audit, and the measurement that proves the transfer was avoided.

96% treat in place for 26,000+ patients across 130+ facilities in 7 states, provider reached in under 3 minutes. We built the platform and we operate it.

NeverAlone

Virtual care command centers

F.1 · G

Clinical coverage is organized facility by facility and shift by shift, so no one has a single view and scarce specialists cannot be pooled across a region.

We build the layer that lets a small clinical team cover many sites at once: multi-site monitoring, intelligent alerting, routing and triage, and connectivity to whatever monitors and systems each site already has.

Remote monitoring across simultaneous cases at 99.9% vital-sign accuracy and under two second refresh, with universal monitor connectivity. Evaluated by the Geneva Foundation for forward military medical care.

Guardian

Patient engagement

F.3 · Use C

The technology gets bought, deployed, and then not used. CMS scores execution rather than purchase, so a device sitting unused earns nothing and the gap shows up at the next recalculation.

We design for the populations this program actually funds. Passwordless, no learning curve, the staff member as operator rather than the patient, and the caregiver treated as a first-class user rather than an afterthought.

A tablet built for seniors and adults with intellectual and developmental disabilities, deployed across 130+ facilities. Extended into IDD care through a $2.8M state grant we supported from proposal through delivery.

Patient engagement platforms

Revenue cycle management

Sustainability

Grant money does not fix an operating margin. A rural organization that is still losing money on every encounter in 2030 will not keep whatever the grant built.

We build the systems that recover revenue the organization has already earned: assessment accuracy, documentation to coding, denial prevention and revenue integrity. This is the work that decides whether an initiative outlives the funding.

$10M in recovered revenue and $2M in annual quality incentives from assessment optimization. Separately, $10M+ in risk adjustment improvement at over 90% accuracy with patient review 50 times faster.

MDS and PDPM · RAF and HCC

Value-based care platforms

E.1 · E.2 · B.1

States committed to value-based arrangements and to better integration for people covered by both Medicare and Medicaid. Rural providers are expected to operate under those arrangements with no analytics to tell them who needs attention.

We build the decision layer above the systems of record: claims and clinical ingestion, risk stratification, intervention triggers routed to the person who can act, and tracking of whether the intervention actually changed the outcome.

A predictive intervention platform tracking $63.7M in patient spending, with enrolled patients showing a 39% cost reduction against those not enrolled.

Congruity Health · Value-based care

Interoperability and data infrastructure

F.2

Nothing connects. The new system does not talk to the record, the record does not reach the state exchange, and interoperability is a scored factor that gets re-examined every year.

We handle exchange onboarding and data use agreements, patient identity matching, terminology mapping and transport standards, and the conformance work that continues after go-live. Being technology agnostic is a scored requirement, not a sales posture.

60+ systems audited, mapped and consolidated, returning the organization to CMS compliance in under six months with a 25% reduction in technology footprint. Separately, 400+ public datasets from 30+ sources unified into one platform.

Ecosystem modernization · EHR integration

Clinical workforce capacity

D.1

You cannot recruit your way out of a rural workforce gap, and no grant changes that. The only lever inside your control is how many hours each clinician spends away from patients.

We build the systems that give those hours back: ambient documentation, assessment support, scheduling, and back-office automation. This is where practical AI earns its place, measured in clinician hours rather than in pilots.

Ambient documentation running in production, cutting clinical documentation from 45 minutes to 5. Assessment time down 40 to 60 percent for the coordinators who own it.

HealthContext.AI · Ambient scribes

One platform, many health systems

C.1 · Use K

A state funds seventeen rural hospitals at a few hundred thousand dollars each. Seventeen separate procurements against seventeen separate designs spends the money without leaving anything that connects, and none of those awards is large enough to fund a real platform alone.

We build multi-tenant. One solution, funded once, used by every health system in the group, with each organization keeping its own data isolation, its own configuration and its own reporting. It changes what a small award can buy, because the cost of the platform is shared and only the configuration is local. The natural sponsor is the state office, the hospital association or the health information exchange that already reaches all of them.

One multi-tenant platform supporting 26,000+ patients across 130+ facilities in 7 states and eight distinct care populations. Facilities outside the original network now license it directly, which is the same architecture serving unrelated organizations.

Multi-tenant deployment
Our proof

We built it. We run it. Every day.

Most organizations bidding into this program can describe what they would do. NeverAlone is a 24/7 clinical safety net for senior and post-acute care teams that we designed, engineered, and still operate in production. It is not a portfolio piece we walked away from.

26,000+
Patients supported
100,000+
Calls a year, three years running
96%
Treated in place
Up to 30%
Reduction in hospital readmissions
Under 3 min
To reach a licensed provider
130+
Facilities across 7 states
8
Care populations
Under 2 weeks
To onboard a site
The NeverAlone device on a gooseneck stand, showing a live video call with a licensed provider and the resident in a picture-in-picture window

One button. A resident, a family caregiver or a staff member presses it and reaches a licensed provider in under three minutes, around the clock, on a purpose-built device with no password and no learning curve.

That is the easy part to describe and the hard part to operate. Five years of running it is how we know what actually decides whether these programs work: provider licensure state by state, escalation and hand-off, documentation that survives an audit, and rollout across facilities with uneven connectivity.

It also became a durable asset for the organization that funded it. Facilities outside the original network license it today, which is exactly the outcome anyone spending five years of federal money should be planning toward.

We support it 24/7

When a nurse needs clinical backup at 3am, the platform has to work. We are accountable for uptime and reliability, not just code quality. That is the same accountability a funded initiative needs in year three when CMS asks what happened.

We manage the complexity

Third-party provider networks, multi-state licensing, HIPAA compliance and real-time clinical workflows. These are the parts of a rural initiative that look small in an application and decide whether it works.

We keep expanding it

Pharmacy integration, EHR connectivity, new care settings. PointClickCare and Gehrimed are in production, with MatrixCare and Netsmart through FHIR, HL7 and ADT.

From prototype to operating platform

  1. 90 days
    Prototype to a working MVP
  2. 2021
    Independent living pilot
  3. 2022
    Care management platform, then a $2.8M state-funded expansion into IDD care
  4. 2023
    Deployed across 130+ facilities in 7 states
  5. Today
    Eight care populations, and facilities outside the original network licensing it

“The ability to reach rural patients at the press of a button has been transformative, significantly reducing travel time for our nursing staff.”

Ryan McElhinny, CEO, Stonerise Home Health and Hospice
A resident smiling during a video visit on the NeverAlone device

What transfers to an EMS initiative, and what does not

Our 96 percent is measured in post-acute settings, not in EMS field triage. We say so because the people reviewing these initiatives are clinicians and the distinction matters.

Transfers directly

On-demand connection to a licensed provider, sub-three-minute response, the documentation layer, device design for non-technical users, and multi-site operations.

Does not transfer

Field triage protocols, medical direction and ambulance disposition. Those belong to your medical leadership, and we build to your protocol rather than importing ours.

More production proof in the same setting

No form, no email

Take the two-page partner brief with you

The scored factors we build against, what runs in production today, how an engagement is funded, and the licensing option. Two pages, printable, and nothing to fill in. Forward it to whoever else has to agree.

Security and compliance

Built to handle PHI, because it already does

Cybersecurity is a funded and scored part of this program, and several states wrote security assessments into their applications. Our platforms carry protected health information in production today.

HIPAA compliant in production

NeverAlone handles PHI for 26,000+ patients across 7 states. This is an operating posture, not a policy document.

NIST and HIPAA-aligned controls

AES-256 encryption at rest, TLS 1.2 and above in transit, role-based least-privilege access, centralized logging, and static and dynamic security testing in the build pipeline.

AWS, HIPAA-eligible services, under a BAA

We execute a business associate agreement before any access to systems or PHI, including for any partner we bring on.

What we do not claim

We are not SOC 2 Type II certified and we are not HITRUST certified. If your program requires either, we scope it as explicit work tied to your production launch rather than implying it is already done.

How to work with us

Start small, and fund most of it from the grant

The first two steps are ours to absorb. After that, training and technical assistance is an approved use of funds, so planning and architecture can be paid for by the award rather than out of margin.

Free to you Fundable from your grant →
01 No cost

Introduction

A conversation about what your organization committed to and where the delivery risk sits. No deck.

02 Fundable, use D

Working Session

A one-day workshop that aligns stakeholders, maps the opportunities inside your funded scope, and picks the highest-return place to start. Any state.

Details →
03 Fundable, use D

Assessment

Four weeks, fixed fee. Quantified return, technical feasibility, and a business case your board and your state program office can both read.

Details →
04 Fundable, use D

Blueprint

One to four weeks turning a funded commitment into a solution architecture, a validated plan and a budget. The document that makes a technical section defensible.

Details →
05 Fundable

Build and operate

Production engineering with a senior US team, then the support that keeps it running. You own the code, the IP and the roadmap from the first commit.

Details →

Readiness review

Forty-five minutes against your own funded scope. We read what your state and your organization committed to before the call.

NO COST
1

What you are scored on

Which technical score factors your funded scope earns against, and which of those are initiative-based, meaning your state has to show follow-through to keep the points.

2

Where it will slip

The parts most likely to run late, and why. Usually provider licensure, exchange integration, or an adoption assumption nobody costed.

3

What fits the clock

What can realistically be in production before your obligation deadline, and what honestly belongs in the next budget period.

4

What the grant can pay for

Whether the work is fundable under training and technical assistance, and what would have to be true for that.

You keep the notes whether or not we work together. If we are not the right partner for your scope, we will say so on the call rather than after the contract.

What can realistically happen before the deadline

The honest answer, because the schedule is the thing most likely to go wrong. Note the distinction CMS draws: money earmarked for future spending is not considered spent. It has to be paid out.

Weeks, not months

A readiness review, a working session and a Blueprint can be complete inside eight to twelve weeks, and each of them is a contracted, payable engagement rather than an earmark. Where the scope really is virtual clinical coverage, NeverAlone onboards in under two weeks.

This budget period

A first production deployment on an existing platform, integration with systems you already run, and the measurement needed to evidence the initiative. Enough to show CMS follow-through rather than intent.

Next budget period

Net-new multi-site platforms, exchange integration across a region, and anything requiring provider licensure in new states. Planning it now is what makes it deliverable then, and the planning itself is fundable.

Also available on its own

You can license NeverAlone directly

Not every funded scope needs an architecture engagement. If the commitment is virtual clinical coverage, the platform is available as a licensed product, it onboards in under two weeks, and it is priced well below the traditional telehealth platforms. That matters when you are working against an obligation deadline rather than a roadmap.

Use our provider network

We partner with provider groups credentialed in the states we serve, including behavioral health, and match them to your location. You get clinical coverage without recruiting for it.

Or use your own

If you already have providers, the platform runs on your network instead. Most organizations we talk to assume a virtual care product means outsourcing their clinicians. It does not have to.

Or both

Your clinicians during the day, a partner network overnight and at weekends. Covering nights and weekends is usually the actual gap, and it is the one staffing cannot close.

Licensing is not a dead end either. It is the same platform we build on, so a subscription today can become an integrated, owned system later without starting again. Paired with the care coordination billing described below, that is what carries a program past 2030.

After 2030

Decide now what you will still own

This program funds five federal fiscal years and then stops. That boundary is the most important date in any plan written today, and it is the one least likely to appear in a vendor proposal.

Some states have already written the cliff into their own plans. Georgia's approach assumes staffing transitions onto other CMS funding in year three, which is a state saying out loud that the money runs out before the need does.

We build so the answer is the third one below. It is also why our contracts assign the code, the intellectual property and the roadmap to the client from the beginning rather than at the end.

STOPS

Rented

The capability stops at the boundary. Whatever the initiative achieved goes with it, and the score it earned is not repeatable.

BECOMES YOUR COST

Bought

You own a maintenance obligation you now have to staff and fund alone: hosting, licensing, support, and the upgrade that arrives in year four.

SURVIVES

Built and transferred

You own an asset, your team can run it, and the cost of ownership was budgeted before the first invoice. In the best case it earns revenue. Facilities outside the original network license NeverAlone today, which is what that looks like in practice.

The mechanism most plans are missing

Grant money builds it. Care coordination billing runs it.

RHTP funds cannot duplicate or supplant existing federal, state or local funding, so the program will not pay for a service Medicare already reimburses. Read that rule the other way round and it points straight at how these programs survive 2030.

Now, 2026 to 2030

The grant pays to build it

  • The platform and the devices
  • Enrollment and consent workflow
  • Contracting a credentialed provider network
  • Staff training
  • The coding and billing capacity most rural organizations do not have

Allowable, and much of it sits under training and technical assistance.

After the money stops

Billing pays to run it

  • Chronic care management (CCM)
  • Principal care management (PCM)
  • Remote physiologic monitoring (RPM)
  • Behavioral health integration (BHI)

Existing Medicare and Medicaid mechanisms. The revenue does not stop in 2030.

Providers often underuse payment mechanisms for care coordination services due to lack of awareness or capacity in coding and billing. Collecting this additional revenue could help offset the costs of the community health providers and sustain these projects.

CMS, Rural Health Transformation Program funding opportunity, population health infrastructure example initiative

This is why we treat the provider network, the documentation layer and the coding capacity as one system rather than three projects. A virtual care program that cannot produce billable, defensible documentation has an expiry date on it. Ours already does: ambient documentation runs inside NeverAlone in production, and separately we have recovered more than $10M in risk adjustment for a post-acute operator at over 90 percent accuracy.

Reading

A six-part series on delivering Rural Health Transformation initiatives

Written for the people who now have to build what their state promised. Publishing through September 2026.

How Rural Health Transformation Program funding is scored
Healthcare

How Rural Health Transformation Program funding is scored

The eleven approved uses, the two halves of the $50 billion, and why your state's score is recalculated every year.

August 17, 2026

Coming soon

Who does what in the Rural Health Transformation Program

States, program consultants, subrecipients and aggregators. Where the money moves and who actually builds.

Coming soon

Coming soon

Treat in place versus transport

Remote care and EMS are two of the highest weighted factors CMS scores. Here is what the build involves.

Coming soon

All insights →

Request a readiness review

Forty-five minutes against your own funded scope. We will tell you what we think is hard about it and what we would watch out for. No cost, no deck, and you keep the notes either way.

Request a readiness review

Not ready to talk? Read the two-page partner brief, no form required.

Or call: 404.654.3855