Can an MCO receive RHTP funds?

It depends on the state. In states where the Medicaid agency runs the RHTP program, MCOs can be the intermediary the state routes regional funds through. In states where the Department of Health runs RHTP, MCOs are usually adjacent partners rather than recipients.

What does anti-supplantation mean for an MCO?

RHTP cannot finance the non-federal share of Medicaid or CHIP. That is the bright line. RHTP can fund transformation initiatives that sit alongside Medicaid (workforce sustainability for the network, telehealth buildouts that change access, value-based readiness for downstream providers), but it cannot replace state Medicaid dollars.

Can RHTP fund value-based contracts MCOs are running?

The capability buildout, yes; the per-member-per-month payment itself, no. RHTP can fund the analytics infrastructure, the care-management buildout, the provider readiness work that enables a value-based arrangement. The arrangement's actual payments come from the Medicaid program, not RHTP.

How should MCOs participate in plan design?

Attend listening sessions and submit feedback during the design window. Where the Medicaid agency is the lead, MCOs are natural partners and often shape the design. Where the Department of Health is the lead, MCO participation is more of a coalition role.

Are dual-eligible programs in scope?

Initiatives that improve rural dual-eligible access (D-SNP coordination, integrated care models, social-needs interventions) are common matches in state plans, particularly in states where the Medicaid agency is running the program.

For your role

RHTP for Medicaid managed care plans.

MCOs can act as state-routed intermediaries in several states, especially where the Medicaid agency is running the program. The role is state-specific and not universal; the question is which states have you in scope and which do not.

Your money path

Where MCOs fit, by state.

01

Intermediary in Medicaid-agency-led states.

In states where the Medicaid agency is the RHTP lead, MCOs are often the routing channel for provider-network buildouts, value-based readiness, and care-coordination programs. The agency designates the intermediary role; it is not automatic by being an MCO.
02

Partner in Department-of-Health-led states.

Where the Department of Health is the lead, MCOs are usually adjacent partners rather than recipients. The collaboration runs through joint design work with hospitals, FQHCs, and other recipients in your network.
03

Capability builder for downstream value-based work.

RHTP can fund the analytics infrastructure, care-management buildouts, and provider-readiness work that makes value-based contracting credible. The downstream arrangement is Medicaid; the readiness investment is RHTP.

What you need

Prerequisites to participate.

State-by-state mapping

Know which of your contract states have the Medicaid agency as RHTP lead, and which have the Department of Health. The intermediary route is generally available only in the first group.
Anti-supplantation discipline

Document the boundary between RHTP-funded transformation work and Medicaid-funded operations. RHTP cannot finance the non-federal share of Medicaid or CHIP.
Federal grants posture

SAM.gov registration, UEI, 2 CFR Part 200 compliance systems. Most MCOs already have these for other federal flows; confirm currency.
Network-engagement plan

If you are the intermediary, you are accountable for downstream subrecipient management. Pre-build the procurement and monitoring playbooks for re-distribution.

How to frame

Anti-supplantation, then sustainability.

Two framings decide most outcomes, and both lean harder on MCOs than on most other recipients because of the proximity to Medicaid.

Beat the anti-supplantation trap

Frame the request as new transformation that sits alongside Medicaid, never as backfill. Workforce sustainability for the rural network, telehealth access expansion, and value-based readiness are defensible categories. Any framing that reads as "fund our existing capitation work" fails.

Answer "what pays for this after 2030"

For MCOs, the post-2030 bridge is usually built into the actuarial soundness of Medicaid managed-care rates and the value-based arrangements the readiness work enables. Show that bridge in the plan.

Where to start

The next links.

How to get RHTP money the capture playbook, with the route by organization type.
How RHTP money flows the statute, the caps, anti-supplantation, sustainability.
Value-based-care capture map the readiness and APM pools that build toward Medicaid downstream contracts.
Behavioral-health capture map the integration and access pools relevant to managed-care networks.
Federal program reference the ten statutory allowable uses and the rules every state plan answers to.

FAQ

MCO questions, answered.

Can an MCO receive RHTP funds?

It depends on the state. In states where the Medicaid agency runs the RHTP program, MCOs can be the intermediary the state routes regional funds through. In states where the Department of Health runs RHTP, MCOs are usually adjacent partners rather than recipients.
What does anti-supplantation mean for an MCO?

RHTP cannot finance the non-federal share of Medicaid or CHIP. That is the bright line. RHTP can fund transformation initiatives that sit alongside Medicaid (workforce sustainability for the network, telehealth buildouts that change access, value-based readiness for downstream providers), but it cannot replace state Medicaid dollars.
Can RHTP fund value-based contracts MCOs are running?

The capability buildout, yes; the per-member-per-month payment itself, no. RHTP can fund the analytics infrastructure, the care-management buildout, the provider readiness work that enables a value-based arrangement. The arrangement's actual payments come from the Medicaid program, not RHTP.
How should MCOs participate in plan design?

Attend listening sessions and submit feedback during the design window. Where the Medicaid agency is the lead, MCOs are natural partners and often shape the design. Where the Department of Health is the lead, MCO participation is more of a coalition role.
Are dual-eligible programs in scope?

Initiatives that improve rural dual-eligible access (D-SNP coordination, integrated care models, social-needs interventions) are common matches in state plans, particularly in states where the Medicaid agency is running the program.

See which states have you in scope.

The Atlas tells you which lead agency runs RHTP in each of your states and where MCOs fit, with the source behind every fact.

Start your Atlas Score your readiness