This narrative strategically aligns the CMS RHTP program requirements, including specific terminology, scoring factors, timeline details, and structural elements from official webinar materials, with the demonstrated capabilities of the HealthSaaS/Akelex platform. The result is a compelling presentation of how our agentic workflow technology enables value-based care delivery and patient engagement to improve population health management.

Rural Health Transformation (RHT) Program
https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview

Notice of FundingOpportunity Webinar – SLIDES
https://www.cms.gov/files/document/rht-program-applicants-webinar-presentation.pdf

Rural Health Transformation(RHT) Program Overview Webinar - TRANSCRIPT

https://www.cms.gov/files/document/rht-program-applicants-webinar-transcript.pdf

The HealthSaaS - Akelex solution directly addresses the five strategic goals of the Rural Health Transformation (RHT) Program established by Public Law 119-21, Section 71401.

Our Ontological - Agentic AI solution enables states to transform rural healthcare delivery through
sustainable, technology-driven solutions.

Core Philosophy: Prevention and therapeutic optimization deliversuperior outcomes at lower costs, the foundation of Value-Based Care and critical to achieving the RHT Program’s goal of affordable, high-quality care through sustainable healthcare innovation.

The solution from HealthSaaS - Akelex transforms data into actionable intelligence, validates outcomesthrough rigorous Continuous Quality Improvement (CQI) processes, and continually refines care delivery. This isn’t temporary relief; it’s catalytic funding creating transformative change with sustainable impact beyond the five-year program period.

Direct Alignmentwith All Five RHT Strategic Goals

1. Improve Rural American Health

Support health innovations and new access points to promote preventive health and address root causes of diseases.
Our platform promotes evidence-based, measurable interventions for prevention and chronic disease management through automated health monitoring, early intervention protocols, and AI-powered assessment of root causes before conditions deteriorate.

2. Sustainable Access

Help rural providers becomelong-term access points for care by improving efficiency and sustainability.

HealthSaaS - Akelex Solution: The force multiplier effect enables existing clinical staff to monitor 1,000+ patients simultaneously, dramatically improving efficiency and creating sustainable operational models that don’t depend on continued subsidies. This addresses the fundamental challenge: transforming care delivery to improve access, quality, and cost in a manner that extends beyond temporary funding.

3. Workforce Development

Attract and retain high-skilledhealthcare workforce by strengthening recruitment and retention in rural
communities.

HealthSaaS - Akelex Solution: By amplifying clinical capacity through technology, CarePath makes rural practice more sustainable and rewarding for clinicians. Nurses focus expertise on high-value interventions rather than routine data collection, improving job satisfaction and retention. This directly supports workforce initiatives with minimum 5-year service commitments.

4. Innovative Care

Spark growth of innovative caremodels to improve health outcomes, coordinate care, and promote flexible care
arrangements.

HealthSaaS - Akelex Solution: Our platform supports innovative models of careincluding value based arrangements and alternative payment models. The ORDS methodology provides the quantifiable evidence and systematic workflow metrics necessary to demonstrate outcomes in VBC arrangements—essential for long-term financial solvency.

5. Tech Innovation

Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients.

HealthSaaS - Akelex Solution: Represents cutting-edge implementation of device telemetry monitoring, artificial intelligence, and consumer-facing technology solutions specifically designed for rural healthcare transformation.

Qualifying Uses of RHTP Funds (Minimum 3 Required)

States must usefunding for at least 3 approved use of funds categories.

HealthSaaS - Akelex solutions directly enable multiplequalifying categories:

A. Prevention and Chronic Disease Management ✓

• Evidence-based interventions using ORDS methodology applied to peer-reviewed literature

• Measurable improvements in chronic disease management through continuous monitoring

• Early intervention preventing disease progression

B. Consumer-Facing Technology Solutions ✓

• Bluetooth-enabled devices for patient engagement (BP monitors, pulse oximeters, glucometers, weight scales, Smart pillboxes, thermometers)

• Consumer-facing digital questionnaires combining withobjective device data

• Technology-driven solutions accessible inpatients’ homes

C. Training and Technical Assistance ✓

• Comprehensive implementation support fortechnology-enabled solutions

• Training for remote monitoring, AI-driven care delivery

• Clinical workflow integration and ongoing technicalassistance

D. IT Advances ✓

• Software solutions improving efficiency and patientoutcomes

• Enhanced data security and interoperability

• Seamless integration with existing health ITinfrastructure

E. Innovative Care Models ✓

• Support for value-based care arrangements andalternative payment models

• Documentation infrastructure required for innovativepayment arrangements

• Coordination and data-driven decision-makingcapabilities

F. Fostering Collaboration ✓

• Our platform enables regional partnerships between rural facilities and referral centers

• American Heart Association collaboration strengthensquality improvement initiatives

• Data sharing and best practice dissemination acrossprovider networks

Statutory “Rural Health TransformationPlan” Requirements

The RHT Programrequires states to address eight mandatory elements (42 USC 1397ee(h)(2)(A)(i))

The HealthSaaS - Akelex solution directly supports:

1. Improving Access to Healthcare Services

Remote monitoring extends specialized clinical oversight without requiring physical infrastructure expansion or patient travel.

2. Improving Health Outcomes

ORDS methodology and AI-poweredearly intervention demonstrably reduce hospitalizations, improve medication adherence, and optimize therapeutic outcomes.

3. Technology Use for Prevention and Chronic Disease

Ontological-Agentic AI platformcombining remote monitoring, artificial intelligence, and consumer-facing technology specifically designed for these applications.

4. Local and Regional Partnerships

American Heart Associationcollaboration provides third-party validation, research participation, and quality improvement infrastructure that strengthens state applications and ongoing performance measurement.

5. Data-Driven Solutions to Deliver Care Closeto Home

Telemetry data and AI-powered assessments enable high-quality care delivery in residents’ homes and communitysettings without requiring facility-based visits.

6. Financial Solvency Strategies
Force multiplier effect and operational efficiency gainscreate sustainable cost structures extending beyond RHTP funding period.The platform demonstrates pathway to long-term viability rather than temporary relief.

HealthSaaS - Akelex Solution: ORDS TherapeuticOptimization Methodology
Unlike simple threshold-basednotifications creating alert fatigue, our proprietary ORDS scoring methodology systematically evaluates care patterns against peer-reviewed literature:

• Optimal: Care aligns perfectly with evidence-based bestpractices

• Reasonable: Care follows acceptable clinical standards with minor enhancement opportunities

• Defensible: Care meets minimum standards but has identifiable gaps

• Suboptimal: Care patterns indicate significant optimization opportunities requiring intervention

Applied Across Six Clinical Categories:

1. Health status and vital trends

2. Wellness and preventive care

3. Prevention of disease progression

4. Engagement and adherence

5. Therapeutic optimization

6. Quality of life metrics

This evidence-based classification ensures care teams receive nuanced, literature-backed clinical insights, not generic alerts, while providing the quantifiable evidence necessary for CQI reporting, milestone tracking, and demonstrating transformative impact.

Measurable Outcomes and Performance Metrics

States must identify at least four quantifiable metrics for each initiative, including at least onedemonstrating county or community-level impact.

HealthSaaS - Akelex Solution enables comprehensiveoutcome tracking:

Access Metrics:

• Reduction in specialist appointment wait times throughremote monitoring

• Percentage of rural patients with access to specializedcare oversight

• Geographic distribution of care access improvements bycounty

Quality and Health Outcomes:

• Rural hospital readmission rate reductions

• Chronic disease management metrics (HbA1c, bloodpressure control, medication adherence)

• Emergency department utilization for preventableconditions

Financial Metrics:

• Operating cost reductions through prevention and earlyintervention

• Reduced acute care utilization and associated costs

• Return on investment calculations fortechnology-enabled care

Workforce Metrics:

• Clinical capacity enhancement (patients monitored perclinician)

• Clinician satisfaction and retention rates

• Recruitment success in technology-enhanced practiceenvironments

Technology Use Metrics:

• Percentage of rural patients engaged withtelehealth/remote monitoring

• Device utilization and data collection consistency

• AI-powered intervention accuracy and appropriateness

Program Implementation Metrics:

• Milestones achieved across implementation stages 0-5

• Number of facilities/providers participating

• Patient enrollment and engagement rates by county

American Heart Association Partnership: Third-PartyValidation

Our collaboration with the American Heart Association strengthens state RHTP applications by providing:

• Independent outcomes validation meeting CMSrequirements for third-party assessment

• Access to cutting-edge cardiovascular health managementprotocols

• Participation in groundbreaking outcomes research

• Thought leadership positioning in rural healthinnovation

• Credibility for state reporting and milestonedocumentation

De-identified Outcomes Analysis: The AHA conducts ongoing outcomevalidation measuring clinical notification accuracy, care team performance metrics, service enhancement opportunities, and population health trends; all data points valuable for annual RHTP reporting and demonstrating progress toward full score potential.

HealthSaaS - Akelex solution createssustainable solutions:

The Force Multiplier: Addressing Rural Workforce Shortages - Ruralhealthcare’s fundamental challenge is workforce scarcity.

Technology-Enhanced Model: 1,000s of patients monitored simultaneously through:

• Automated data collection from Bluetooth-enableddevices

• AI-powered assessments combining objective and subjective data

• Intelligent triage notifications stratified by severity

• Literature-backed clinical rationale for every recommendation

• Focused interventions where nurses receive prioritized alerts

Result: Technology-enhanced monitoring allows scarce clinical resources to focusexpertise on high-value interventions while automated systems handle continuous monitoring, the operational efficiency and clinical effectiveness that sustainable rural healthcare demands.

Budget Period Alignment and Spending Timeline

With 5 budget periods (FY2026-FY2030) and 23 months to spend each period’s funding, HealthSaaS - Akelex offers:

• Immediate integration with existing clinical workflows in Budget Period 1

• Staged implementation across Stages 0-5 with clearmilestones

• Scalable deployment from pilot programs to system-wide implementation

• Progressive achievement toward full score potentialthrough documented milestones

Implementation Stages:

• Stage 0-1 (Months 1-6): Planning and initial deployment

• Stage 2 (Months 7-12): Implementation underway, plan refinement

• Stage 3 (Months 13-18): Halfway complete, continuousi mprovement

• Stage 4 (Months 19-24): Deliverables finalized, goals nearly achieved

• Stage 5 (By Month 36): Fully implemented, producing measurable outcomes for reporting

Program-Specific Funding Limitations Compliance

CarePath Health solutions fit within all RHTP fundingrestrictions:

• Capital expenditures: Platform requires minimal infrastructure (<20% cap)

• Provider payments: Not applicable—technology solution,not direct payments (<15% cap)

• EMR replacement: Integrates with existing systems, doesn’t require replacement (<5% cap)

• Administrative expenses: Efficient implementation minimizes administrative burden (<10% cap)

• Prohibited uses: No new construction, no duplication ofbillable services

Sustainability Beyond the Five-Year Program

RHT funding is intended as catalytic funding for transformative change with sustainable impact, not temporary relief creating funding gaps when the program expires.

The HealthSaaS - Akelex solution creates lasting transformation:

Permanent Infrastructure:

• Technology platform becomes embedded in operationalcapability

• Clinical workflows permanently enhanced

• Data infrastructure supports ongoing qualityimprovement

Reduced Ongoing Costs:

• Prevention and early intervention reduce expensiveacute care utilization

• Operational efficiency gains compound over time

• Reduced burden on scarce clinical workforce

Enhanced Revenue Capture:

• Improved quality metrics enable value-based paymentparticipation

• Documentation supports alternative payment models

• Demonstrates outcomes for ongoing state support

Transferable Model:

• Platform adapts to future payment models beyond fee-for-service

• Lessons learned integrate into ongoing state healthcare policy

• Proven approach scales to additional populations and conditions

Technical Score Factors Addressed

The HealthSaaS - Akelex solution aligns with multiplehigh-value technical score factors:

Initiative-Based Factors:

• B.1. Population Health Clinical Infrastructure (3.75%weight)

• B.2. Health and Lifestyle (3.75% weight)

• C.1. Rural Provider Strategic Partnerships (3.75%weight)

• E.1. Medicaid Provider Payment Incentives (3.75%weight)

• E.2. Individuals Dually Eligible for Medicare andMedicaid (3.75% weight)

• F.1. Remote Care Services (3.75% weight)

• F.2. Data Infrastructure (3.75% weight)

• F.3. Consumer-Facing Tech (3.75% weight)

Data-Driven Factors

• E.2. Dual Eligibles - Platform particularly effective for complex, high-need populations

• F.2. Data Infrastructure - Enhances state’s datacollection and analysis capabilities

State Policy Action Factors:

• F.1. Remote Care Services - Supports state policyactions around telehealth and remote monitoring

Scoring Criteria Excellence

For each initiative-based factor,merit reviewers assess applications on five criteria (20 points each, 100 points maximum):

1. Strategy (20 points max)

Clear, evidence-based approach applying peer-reviewed literature through ORDS methodology to address specific rural health challenges identified in state needs assessment.

2. Workplan and Monitoring (20 points max)

Detailed implementation timelineacross Stages 0-5, clear milestones, comprehensive performance tracking through AHA partnership providing third-party validation.

3. Outcomes (20 points max)

Specific, measurable outcomesacross access, quality, financial, workforce, and technology metrics with baseline data and county-level granularity.

4.Projected Impact (20 points max)

Quantifiable improvements inrural health access, outcomes, and provider sustainability with documented ROI and force multiplier effects.

5. Sustainability (20 points max)

Permanent infrastructure gains reduce ongoing costs, enhanced revenue opportunities, and integration into state policy beyond five-year program period.

Application Support Services

The HealthSaaS - Akelex solution provides comprehensivesupport for states developing RHTP applications:

Pre-Application Consultation:

• Needs assessment alignment with state rural health landscape

• Initiative design addressing statutory requirements

• Budget narrative development using $200M hypothetical amount

• Technical score factor mapping and optimization

Application Development:

• Project narrative support addressing all seven requiredsections

• Metrics and evaluation plan design with baseline data

• Stakeholder engagement framework development

• Governor endorsement letter support materials

Implementation Planning:

• Detailed timeline development across federal FY26-FY31

• Milestone definition for Stages 0-5

• Subaward and subcontract planning

• Performance tracking and reporting infrastructure

Post-Award Partnership:

• Annual reporting support demonstrating milestone achievement

• Progress documentation toward full score potential

• Workplan updates for non-competing continuation applications

• Technical assistance throughout five-year program period

Cooperative Agreement Partnership

The RHT Program operates as acooperative agreement requiring substantial collaboration between CMS and states.

HealthSaaS - Akelex approach aligns withthis partnership model:

• Regular stakeholder coordination including state healthagencies, Medicaid agencies, offices of rural health

• Formal engagement framework with documented processes

• Annual progress reporting demonstrating milestone achievement

• Adaptive management adjusting approach based onoutcomes data

• Transparent communication with CMS program office throughout implementation

Key Milestones and Deadlines

• September 30, 2025: Letter of Intent deadline (optional but encouraged)

• November 5, 2025, 11:59 PM ET: Application submission deadline via Grants.gov

(ONE-TIME OPPORTUNITY)

• December 31, 2025: Expected award announcements

• January 2026: Distribution of Budget Period 1 funds

• Annual rescoring: Workload funding recalculated based on progress each year

Why HealthSaaS, Akelex for Your State’s RHTP Application

Proven Technology addressing multiple strategic goals, uses of funds, and technical score factors
Comprehensive Metrics enabling county-level outcome reporting and milestone tracking

· Third-Party Validation through American Heart Association partnership providing independent assessment

· Sustainable Model creating permanentinfrastructure and operational efficiency beyond temporary funding

· Implementation Expertise supporting states fromapplication development through five-year program completion

· Transformative Impact documented throughevidence-based ORDS methodology and continuous quality improvement

Contact HealthSaaS – Akelex to discuss strengthening your state’s Rural Health Transformation Programapplication and creating sustainable rural healthcare delivery in your communities.

The HealthSaaS - Akelex Solution: Transformation Promise

"Individuals with complex health challenges andrequire sophisticated, evidence based therapeutic optimization that coordinates multiple conditions, prevents dangerous interactions, and ensures every clinical decision is supported by peer-reviewed medical science"

When implemented community-wide, this proactive approach transforms rural healthcare environments from reactive crisis management preventive wellness communities

This is the sustainable rural health transformation that the Rural Health Transformation Program envisions, not temporary relief, but catalytic investment creating lasting change

Conclusion: Strategic Partnership for RHTP Success

The HealthSaaS - Akelex solution represents theintersection of the RHT Program's five strategic goals, eight statutory requirements, multiple qualifying uses of funds, and high-value
technical score factors. Our platform doesn't just help states access RHTP
funding. We help deliver the transformative outcomes that:

• Justify continued state investment beyond the five-year program

• Position organizations for success in post-RHTP value-based care landscape

• Document measurable impact for annual CMS reporting and score increases

• Create sustainable operational models extending beyond temporary funding

• Make rural America healthy again through technology-driven innovation

For states developing RHTP applications, the HealthSaaS - Akelex solution offers the comprehensive solution that turns the $50 billion Rural Health Transformation Program opportunity into lasting rural healthcare transformation.

Contact Information

Frank Ille

frank_ille@carepath.health