Oklahoma Rise 25 in 25: RHTP Forum

Oklahoma Rural Health Transformation Program (RHTP): A $1.1 Billion Rural Opportunity

Welcome to the Oklahoma Rise 25 and 25 RHTP Forum podcast. This is a production of the Oklahoma Rise 25 and 25 RHTP Task Force. An independent, Oklahoma-led collaborative focused on turning one of the most significant rural health investments in our state's history into real, measurable outcomes for our communities.
In this episode we take a Deep Dive into the Rural Health Transformation Program (RHTP), moving beyond headlines to explain what the program means, how it works, and what successful execution will require across Oklahoma. Host(s) and guests -- including members of the Oklahoma Rise 25 and 25 RHTP Task Force and health policy experts -- unpack the sobering baseline data: Oklahoma ranks 47th in overall health, seven rural hospitals lost in the last decade, nearly 30% of remaining rural hospitals at immediate risk of closure, and a median operating margin of negative 16% for Critical Access Hospitals with 79% rated medium or higher financial risk.
The episode explains scale and scope: CMS awarded Oklahoma one of the largest state awards nationally for this program — a projected $1.17 billion over five years (with an estimated $223.5 million in 2026 alone) — and lays out the RHTP mission to shift care from fragmented fee-for-service to coordinated, value-based, population-focused models that are sustainable after federal funding ends.
Listeners learn the six strategic pillars that form the RHTP roadmap and the funding priorities behind them: facilitating regional collaboration (~$417M) with $176M for the Rural Regional Reorientation Plan and $212M+ for Clinically Integrated Network (CIN) development; innovating care delivery (~$151M); shifting to value-based payment (~$102M); building a health data utility (~$96M); moving upstream on prevention and social needs (~$94M); and growing next-generation rural talent (~$68M).
The episode digs into specific initiatives and implementation details: regional stabilization and strategic right-sizing to strengthen networks rather than preserving unsustainable service lines; CINs as the organizational backbone that give rural providers scale and negotiating leverage; EHR expansion (~$45M) and HIE interoperability to solve a massive data gap (97% of rural health clinics not connected); a consumer-facing consent app for behavioral health data; value-based practice enablement (up to $100K per practice per year to support 150–200 practices); PCP clinical extension models ($37M) to provide centralized population-health support; PACE expansion (~$33M) to create 3–6 rural PACE centers; a technology cooperative (~$65.75M) to lower the cost of remote monitoring and AI documentation; and a community health worker expansion ($10.8M) to reduce readmissions by addressing social needs.
Key takeaways and measures of success are highlighted: the central metric is financial sustainability — the hope that successful RRT reorientation and value-based practice transitions will shift the median CAH operating margin from the current negative 16% to a sustainable positive number. The episode also explains near- and long-term goals of the Rise 25 and 25 initiative: move Oklahoma from 47th to the top 40 within five years and to 25th by 2050.
Practical next steps and engagement: the Task Force’s role in accelerating implementation with data, AI, and on-the-ground support is explained, and listeners are invited to join the coalition at rise25in25.org or email info@rise25in25.org. The episode closes with a preview of the next Deep Dive, which will focus on the largest pillar — facilitating regional collaboration — and the detailed implementation blueprint for the Rural Regional Reorientation Plan and CIN development.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Oklahoma’s $210+ Million Bet: Build a Clinically Integrated Network for Rural Health Survival

Welcome to the Oklahoma RISE 25 and 25 RHTP podcast. This episode delivers a focused, practical deep dive into the Clinically Integrated Network (CIN) Development Initiative, the single largest investment in Oklahoma’s Rural Health Transformation Program: an approximately $212.7 million, five-year initiative designed to solve the structural fragmentation threatening rural hospitals and clinics.
In this episode we explain what the CIN is, how it will be organized as a member-owned Rural Health Collaborative Nonprofit under the oversight of the Oklahoma State Department of Health, and why the CIN is positioned under the Facilitating Regional Collaboration strategic pillar. We cover the aggressive timeline (establishment and operational readiness in fiscal year 2026), the lean initial staffing model, and the competitively procured management support vendor approach (a budgeted vendor contract at roughly $6M per year).
Topics covered include the CIN’s four spending categories: shared administrative supports (group purchasing, centralized billing, and contract negotiation), shared clinical supports (telemedicine, specialty staffing pools, care coordination), governance and leadership development (board training and rules of engagement), and enabling technology infrastructure (population health management, referral management, remote monitoring, AI-enabled documentation). We describe how these investments are intended to deliver an estimated 20% administrative savings for members and enable value-based care participation.
The episode details the program’s measurable targets and accountability metrics: 20% of eligible facilities signed up and participating by year two, 30%+ by year three, documented 20% administrative savings by year four, and 100% of CIN members in at least one value-based care (VBC) arrangement by year four. We also explain county-level reporting requirements for VBC participation and the Financial Stability Index.
We put the CIN into context with Oklahoma’s current rural health crisis: median operating margins for Oklahoma critical access hospitals at –16% (–5% total margin including non-operating revenue), roughly $663M in uncompensated care statewide, a median uncompensated care ratio of 5.37% (versus 2.84% nationally), seven rural hospital closures in the last decade, 79% of CAHs rated medium-or-higher financial risk, and 30% of remaining rural hospitals at immediate risk of closure.
The episode unpacks the CIN’s crucial dependencies and sequencing: it must be tightly coordinated with the Rural Regional Reorientation Plan (the blueprint for optimal regional referral patterns), the EHR Expansion initiative (~$45M) and the HIE Interoperability initiative (~$30M) to provide the data inputs the CIN’s PHM and analytics need, and complementary programs such as the Value-Based Care Practice Enablement and the Technology Cooperative for PCP and behavioral health. We warn of the ‘‘platform without data’’ risk if technology is deployed out of sequence.
Key execution risks and failure points are highlighted: failure to hit participation thresholds (the essential scale problem), technology non-use or poor adoption, misalignment with the regional reorientation blueprint, and insufficient vendor performance monitoring. The episode describes the governance challenge of persuading fiercely independent rural providers to join a member-owned, collective model and the investments intended to build trust — stakeholder engagement, front-loaded governance consulting, and sustained leadership training.
Listeners will hear the practical, accountability-focused monitoring approach proposed: quarterly vendor reviews, deliverables-based invoicing, and four critical success factors to track—member recruitment, governance effectiveness, technology implementation and utilization, and successful VBC transition that demonstrates sustainable revenue after RHTP funding ends in 2031.
Who should listen: hospital and clinic leaders, board members, tribal health partners, payers, policymakers, and community stakeholders who want a clear, operational view of how Oklahoma plans to move from fragmented, fragile rural care to coordinated, scale-enabled networks capable of participating in VBC and reducing closure risk.
By the end of the episode you’ll understand why the CIN is more than a grant program: it is strategic seed capital intended to create a self-sustaining, provider-owned infrastructure that addresses Oklahoma’s uniquely severe rural hospital vulnerabilities and sets a potential national model for rural health transformation.Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Rural Regional Reorientation Plan: Driving Towards Rural Facility Sustainability

In this episode we take a deep dive into Oklahoma's Rural Regional Reorientation Plan—the centerpiece of the Rural Health Transformation Program—explaining why the state is committing $176,060,000 across FY2026–FY2031 to remake rural care delivery. Hosts and guests including state health officials, RHTP task force members, regional hospital leaders and policy experts unpack the scope of the crisis driving the effort (1.58 million rural residents affected, seven hospitals lost in the last decade, a 30% immediate closure risk, and a median operating margin of –16% among CAHs) and the strategic reasoning behind a one‑time investment intended to produce self‑sustaining regional networks.
Topics covered include the plan’s strategic framing and alignment with CMS goals for sustainable access and innovative care; the three‑phase timeline (FY2026 data baseline and planning, FY2026–FY2027 hospital‑driven regional strategy development, and FY2027–FY2031 plan consolidation and implementation); the technical assistance model and $15M TA vendor role; and the governance structure spanning a Statewide Steering Committee, regional working groups, an advisory council that includes tribal partners, and 10 regional RHD champions to coordinate locally.
The episode breaks down the funding mechanics and participation incentives—$150,000 planning payments per participating hospital, and a $158M implementation pool that includes $42M in provider implementation payments, $85M for infrastructure renovations, and $21.25M for new capacity, equipment and staffing—plus the conditional, milestone‑driven release of funds. We also explain the intended shift from a facility‑centric to a region‑centric model: strategic right‑sizing of services, consolidation of expensive duplicated assets, centralized EMS routing, clinically integrated networks (CINs), telehealth and community paramedicine, and alignment with value‑based payment to preserve long‑term sustainability.
Key points and risks are highlighted: the central metric of success is improved operating margins and financial stabilization; major execution risks include a compressed data and planning timeline (Q3 FY26 baseline sprint), data system and HIE delays, community and political resistance to service changes, and the challenge of securing genuine implementation commitment from 80% of targeted hospitals. The episode also stresses tribal sovereignty and the necessity of integrating tribal health systems into planning and governance.
Finally, the conversation closes with practical takeaways for hospital and community leaders: immediate actions include preparing for HIE/interoperability, assessing organizational readiness for CIN membership and new governance/legal arrangements, prioritizing data and analytics readiness, and aligning workforce and residency initiatives with the regional service map so facilities can plug into the new system when implementation funding is released. Listeners will come away with a clear sense of the plan’s ambition, the human stakes, the detailed mechanics of funding and governance, and what must happen now to make the transformation succeed.Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Rural PACE Expansion: Oklahoma’s $33M Investment in All-Inclusive Care for the Elderly

Welcome to the Oklahoma Rise 25 and 25 RHTP podcast. This podcast is a production of the Oklahoma Rise 25 and 25 RHTP Task Force, an independent Oklahoma-led collaborative focused on turning one of the most significant rural health investments in our state's history into real, measurable outcomes for our communities. This podcast moves beyond headlines and funding announcements to provide clear, practical insight into what the Rural Health Transformation program means, how it works, and what successful execution will require across Oklahoma. At its core, this series reflects a belief that Oklahoma's healthcare future can be stronger, more accessible, and more sustainable, especially for rural and tribal communities, when we focus on coordination, accountability, and solutions grounded in the realities of our state.
In this episode we take a deep dive into the PACE Expansion Initiative — a $33,360,000, multi-year investment led by the Oklahoma Healthcare Authority (OHCA) to stand up three to six new rural PACE centers between FY2026 and FY2031. Expect a detailed walkthrough of what PACE is (the interdisciplinary team, the PACE center hub, and the combined Medicare/Medicaid capitation model), why it matters for dual-eligible seniors, and how this model aims to replace costly, fragmented care with proactive, community-based supports.
Topics covered include the program’s alignment with CMS strategic goals (sustainable access and innovative care), lessons from Oklahoma’s existing Rural PACE success (Cherokee Eldercare), and the operational design elements—targeted provider recruitment, startup capital, telehealth and mobile clinic strategies, and a near $9 million OHCA investment in data and analytics needed to run capitated payments.
Guests and voices in the episode include producer/host Dr. Keely John Booth, MD, members of the RHTP Task Force, and conversations with state agency representatives and health policy experts who explain the roles of OHCA and the State Department of Health (OSDH) in administration, contracting, and CMS reporting. Listeners will hear how the initiative connects to other Pillar 4 investments (value-based practice enablement, PCP clinical extension models, community paramedicine) and why coordinated data governance matters to fairly attribute outcomes.
Key points and metrics are made explicit: ambitious enrollment targets (roughly 800 participants in the first year and 1,400+ by year four to reach financial stability), performance goals (15–20% reduction in ED utilization), and the state budget target of a 10% net Medicaid cost reduction per member (from a baseline of approximately $3,721 PMPM to $3,349 PMPM). The episode also breaks down financial instruments like provider incentive payments (up to $666,000 per clinic), the heavy front-loaded budget in FY26–FY27 (approximately $13.31M and $9.81M), and the catalytic role of startup funding to bridge the two-year CMS approval window.
The hosts carefully examine the non-negotiable assumptions and main risks: finding capable rural providers willing to bear financial risk, meeting CMS’s rigorous approval and survey process on a compressed timeline (Q1 FY28 target), achieving community and tribal trust and enrollment, and ensuring interoperable data flows for payment and performance monitoring. The discussion emphasizes sovereignty-respecting tribal engagement and culturally competent design as essential for success.
Listeners will learn what success looks like on the ground (permanent, billable PACE centers that reduce hospital strain and allow frail seniors to remain in their homes), what failure modes to watch for (under-enrollment, CMS delays, insufficient tribal/community buy-in), and the broader system impacts—improved access in HPSAs, better quality of care, and a sustainable path for rural provider revenue streams.
By the episode’s close you’ll understand this initiative’s promise and pressure: the model is proven, the capital is committed, but Oklahoma’s ability to transform care hinges on rapid organizational change, precise site selection, and aggressive execution in the 2026–2027 planning window. Expect practical insights, specific milestones to watch, and a clear sense of what successful PACE expansion would mean for Oklahoma’s rural and tribal communities.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Oklahoma RHTP Primary Care & Behavioral Health Provider Technology Cooperative

Welcome to the Oklahoma Rise 25 and 25 RHDP podcast. This podcast is a production of the Oklahoma Rise 25 and 25 RHDP Task Force, an independent Oklahoma-led collaborative focused on turning one of the most significant rural health investments in our state's history into real, miserable outcomes for our communities. This podcast moves beyond headlines and funding announcements to provide clear, practical insight into what the Rural Health Transformation program means, how it works, and what successful execution will require across Oklahoma.
In this Deep Dive episode the focus is on the structure of modernization within Oklahoma’s RHTP framework, centering on a $65.75 million technology cooperative for primary care and behavioral health providers. We unpack where the cooperative sits within RHTP’s goals, the Oklahoma State Department of Health’s role as lead agency, the implementation timeline (FY2026–FY2030) and the staged rollout and pilot strategy that will test sustainability and adoption.
Topics covered include the cooperative’s dual function as a group purchasing engine and continuous technical-support hub; governance and membership design; master contracting and group purchasing savings targets (10–25%); and the three priority technology categories targeted for procurement and implementation — remote patient monitoring (RPM), telehealth platforms, and AI-enabled clinical documentation. The episode also examines dependencies on parallel investments (EHR expansion and HIE interoperability), how the cooperative complements — rather than competes with — larger initiatives like the CIN and rural health collaborative, and why sequencing and integration are critical.
Guests and contributors in the conversation include Dr. Keely John Booth, MD (host/producer), representatives and experts from the Oklahoma State Department of Health and the RHTP Task Force, and other program stakeholders and implementation partners. The discussion blends operational detail, policy context, and frontline perspectives so clinic administrators, policy leaders, and community members can understand practical risks and opportunities.
Key takeaways and measurable goals highlighted in the episode: the cooperative aims to reduce administrative burden and provider burnout (targeting ~20% documentation time savings by years 3–5), enable RPM-driven reductions in hospitalizations (estimates cited of 20–30% for targeted chronic conditions), and create a provider-assumed, dues-funded sustainability model backed by documented 10–25% technology cost savings. Critical milestones include a small pilot (25–30 providers) and a formal pilot evaluation in Q4 FY2028, with a Q2 FY2029 sustainability proof point required to justify the transition to member-funded operations.
The episode also outlines major failure risks to monitor — mismatched technology for low-bandwidth settings, insufficient implementation and workflow-focused support, and lack of transparent ROI or trust — and the success factors required: strong, representative governance, strict procurement discipline, deep coordination with EHR and HIE efforts, transparent performance monitoring, and rigorous measurement of cost and workflow outcomes.
Listeners will leave the episode with a clear sense of what the cooperative is designed to solve, how it will operate, what success will look like on the ground, and why this initiative could be a replicable model for rural health modernization beyond Oklahoma.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Oklahoma's Plan to Move Upstream for Chronic Disease Prevention and Management

In this detailed episode we unpack Oklahoma’s Chronic Disease Prevention and Management (CDPM) program — a $39,450,000, five‑year investment (FY2026–FY2031) led by the Oklahoma State Department of Health (OSDH) as part of the Rural Health Transformation Programs (RHTP) Moving Upstream strategy. We trace how the initiative aims to shift care from reactive, high‑cost interventions to prevention and early management across all rural counties, with a central, non‑negotiable goal: sustainability through provable return on investment (ROI) so successful programs become permanently billable services.
Guests and voices include OSDH program leads, representatives from the Oklahoma Health Care Authority (OHCA) and OKShine, tribal health leaders (including lessons from the Chickasaw Nation and the Special Diabetes Program for Indians), technical assistance vendors, and local community program implementers. Together they explain the operational blueprint, evidence base and the interagency coordination required to make the CDPM work.
We break down the program design: a competitive NOFO process with strict guardrails — condition targeting (areas exceeding national averages), alignment with evidence‑based models, rigorous outcomes measurement, and an innovation priority for consumer‑facing technology. Funding covers startup costs, staffing, equipment, outreach, tech build, and technical assistance. The rollout is phased into two staggered cohorts (Cohort 1 in FY2026 and Cohort 2 in FY2028) to enable iterative learning and risk reduction.
The episode highlights the local and national evidence the CDPM must replicate, including the Special Diabetes Program for Indians (SDPI) and Oklahoma’s Total Wellness Program (TWP), and explains why tribal partnerships and culturally competent approaches are essential. Listeners hear how the state is positioning this as a venture‑style public investment: prove the business case with data so Medicaid, Medicare and commercial payers will cover the services long term.
We map critical dependencies and risks: the consumer‑facing technology platform ($15.95M), community health worker expansion ($10.8M), HIE interoperability through OKShine, and the need for OHCA to pursue state plan amendments or waivers. Major operational assumptions (administrative capacity of small community groups, patient engagement with technology, and local care coordination) are called out along with three key success metrics required to persuade payers — 70% participant retention (by year 2), a 5% reduction in complications (years 4–5), and a 10% symptom improvement (by year 5).
We walk through the budget cadence (front‑loaded startup spending in FY2026, a larger launch spike in FY2028, and outcome/transtion focus in years 4–5), the $1.45M technical assistance allocation (front‑loaded and again in year 5 for sustainability planning), and the stage‑zero priorities that must be executed in Q1–Q2 FY2026 (advisory convening, NOFO finalization, TA procurement). The conversation centers on the single biggest operational and strategic challenge: converting proven program outcomes into durable payer reimbursement before funding sunsets.
By episode end listeners will understand why CDPM is less a one‑off grant and more a systemic experiment: a coordinated, data‑driven attempt to reduce preventable hospitalizations, shore up fragile rural hospital finances, improve Oklahoma’s ranking, build a sustainable rural health workforce, and change how chronic care is paid for in the long run. The final takeaway: early, concurrent payer engagement and flawless execution of the FY2026 startup milestones are indispensable to avoid the program failing at the finish line.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Oklahoma's Primary Care Provider Clinical Extension Models: Proactive Population Health Teams

In this episode of the RHTP podcast hosts unpack the Primary Care Provider Clinical Extension Models — a five‑year, $37+ million initiative designed to solve the operational capacity crisis in rural primary care. We walk through the program’s strategic rationale, its high‑risk Medicaid and dual‑eligible focus, and why OHCA is the lead agency driving a plan explicitly tied to value‑based care performance.
The conversation explains what the clinical extension approach is — external, shared operational teams (care coordinators, health coaches, pharmacists, and technology platforms) that do proactive population health work without expanding practice payroll. We describe the three conceptual models: Primary Care As A Service (shared vendor teams), in‑home wraparound support for high‑need dual eligibles, and technology‑enabled remote monitoring with a human response layer.
Listeners get a clear roadmap of the phased rollout: administrative and design work in FY2026, a first cohort of 10 practices in FY2027–28, a pause for measurement and refinement, a second cohort in year four, and comprehensive outcome analysis by Q4 FY2030. We cover the required evidence standard — a risk‑adjusted total cost of care (TCOC) reduction target of 5–10% versus controls — and the technical challenges around attribution, risk adjustment, and robust measurement.
The episode outlines critical dependencies and risks: tight integration with EHR/HIE and practice enablement initiatives, vendor quality and rural expertise, rigorous practice selection, and—most importantly—managed care entities agreeing to transition to PMPM payments to sustain the model after RHDP funding phases down. We explain the staged financial transition (RHTP fully subsidizes early years, then scales down to force MCE buy‑in) and the governance role OHCA must play to coordinate vendors, data flow, and payer negotiations.
Finally, we tie the operational specifics back to the bigger stakes for Oklahoma: stabilizing fragile rural practices and critical access hospitals, improving clinical outcomes and community trust through wraparound care, and generating Oklahoma‑specific evidence to catalyze broader payer adoption. Expect concrete implementation milestones, realistic execution challenges, and a clear sense of what success will look like for patients, providers, and payers.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Oklahoma Moves to Transition from Fee-for-Service to Value-Based Care with RHTP Funding

Welcome to the Oklahoma Rise 25 RHTP podcast. In this Deep Dive episode, hosts and policy experts from the Oklahoma RISE 25 and 25 RHTP Task Force unpack the practice enablement support profile that sits at the heart of Oklahoma’s Rural Health Transformation Program: a $32,050,000, five-year investment to shift rural primary care from fee-for-service to value-based care.
Topics covered include the program’s purpose and scope (150–200 rural primary care practices, including rural health clinics, FQHCs, independent and tribal providers), the role of the Oklahoma Health Care Authority (OHCA) as lead agency, and the funding timeline from FY2026–2030. The episode explains how the investment acts as bridge funding—provider-assumed cost designed to create long-term financial sustainability through shared savings, PMPM payments, and eventual capitation.
Key program design features are detailed: three core components (technology and analytics for risk stratification and performance tracking; expert technical assistance to redesign payment models, negotiate contracts, and build capabilities; and governance development to enable shared-risk arrangements such as ACOs or CINs). Practical mechanics are described, including direct provider enablement contracts that offer roughly $100,000 per practice per year for two years as runway, a phased on‑ramp that begins with upside-only shared savings (launching in Q3 FY27) and moves to two‑sided risk no earlier than FY29 Q1, and the critical sequencing required across RHTP pillars.
The conversation highlights essential cross-pillar dependencies and synergies—PCP clinical extension models, CIN development, HIE and EHR interoperability, the technology cooperative, and PACE examples—and why coordinated execution matters. The hosts identify non-negotiable success metrics (VBC contract participation targets: at least 25% by end of year two and 50%+ from year three; improvement in CMS core set prevention and chronic care measures), vendor deliverables and reporting expectations, and alignment with CMS strategic goals around sustainable access and innovative care.
The episode also outlines major risks and failure points: weak TA vendor selection, lack of payer engagement (both Medicaid and commercial), provider resistance or weak organizational readiness, unreliable data flows, and the danger of moving too fast into downside risk. The FY26 procurement of the TA vendor is emphasized as a critical path item—delays there compress the learning window and jeopardize the five‑year plan.
Listeners will come away with a clear sense of what success looks like on the ground—stabilized clinic finances, proactive population health management, stronger workforce recruitment and retention, and sustainable community access—as well as the practical steps, timelines, and accountability structures needed to get there. The episode ends with a challenge to Oklahoma leaders: are providers and payers ready to assume the accountability that true sustainability requires?
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Building the Digital Backbone: Oklahoma’s RHTP $44.88M EHR Expansion

Welcome to the Oklahoma Rise 25 and 25 RHTP podcast. In this episode we take a deep dive into the EHR Expansion Initiative—the foundational $44.88 million, multi-year investment in certified electronic health records that the Oklahoma Healthcare Authority (OHCA) and the Oklahoma State Health Information Network Exchange (OKSHINE) are coordinating to close the state’s rural digital divide.
Topics covered include the initiative’s goals and timeline (FY2026–FY2031), the targeted first cohort of 40 rural facilities (three hospitals, 20 FQHCs, eight community behavioral health clinics, two substance abuse centers, and seven rural health clinics), and the key requirement that all subsidized systems connect to the statewide MyHealth HIE. We explain why EHRs are the “concrete foundation” for every other RHTP pillar—HIE interoperability, data & analytics, the $65.75M technology cooperative, remote patient monitoring, and maternal health programs—and how those projects depend on connected EHR endpoints to deliver real value.
The episode details the operational design and funding structure—equipment and infrastructure (~$20,000 per site), tiered implementation support (up to ~$1.5M for hospitals, ~$160k for small clinic rollouts), negotiated state-level group licensing to reduce costs, deliverables-based contractor payments, and mandatory HIE participation to prevent new data silos. We review measurable problems this initiative addresses (e.g., up to 97% of rural health clinics disconnected from the HIE, duplicate testing rates of ~20%, and critical access hospitals operating on median margins as low as -16%) and the assumptions and risks that drive sustainability concerns.
Key execution milestones and performance targets are explained: Stage Zero assessment and vendor selection in FY26; a high-visibility target to reach 66% EHR utilization among rural providers by the end of FY2028; and full transition to provider-assumed costs by FY2031. The episode also covers workforce and change management strategies (comprehensive training, peer-to-peer learning community), governance and accountability measures (quarterly monitoring, utilization and satisfaction metrics, >55% provider satisfaction goal), and the respectful coordination approach for tribal health systems.
Listeners will hear practical takeaways for rural providers and health leaders: why early participation is advantageous, what success looks like on the ground, how connected EHRs reduce waste and improve care continuity, and why this initiative is framed as a systems transformation (not a one-time subsidy). Featuring insights from OHCA and OKSHINE initiatives, this episode explains what’s at stake—and what it will take—to make Oklahoma’s rural health transformation work.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.

Health Information Exchange (HIE) Interoperability: Reinforcing Oklahoma's Data Highway

In this episode of the Oklahoma RISE 25 and 25 RHTP podcast. Today we take a deep dive into the Building Health Data Utility pillar of the Oklahoma Rural Health Transformation Program — specifically the $29,210,000 Health Information Exchange (HIE) interoperability initiative led by the Oklahoma Health Care Authority through its OKShine office. Covering all 77 counties and deployed across FY2026–FY2030, the initiative is presented as the critical, foundational “data plumbing” required to unlock the rest of the states $1.1 billion rural health investment.
Hosts discuss the core problem — fragmented patient data and severe rural blind spots — and unpack sobering baseline metrics: 97% of rural health clinics (RHCs) are not connected to the HIE, 46% of rural hospitals lack integration, 40% of substance abuse treatment centers are unconnected, and a statewide 20% duplicate diagnostic testing rate. The episode explains how these gaps create patient-safety risks, wasted spending, and a lack of timely population-level visibility for state decision-makers.
The conversation outlines the initiatives two central marching orders: extend HIE connectivity to unconnected rural facilities, and dramatically expand data ingestion to include imaging, pharmacy, public health, and real-time mortality feeds. It details the four funded components — facility connection and onboarding subsidies, provider adoption and education (including a peer-to-peer learning portal), system upgrades and data integration (notably $2.5M for AI-driven imaging over-reads and a DICOM server), and a consumer-facing consent application to resolve Oklahomas opt-in policy for behavioral health data — and the specific facility targets: ~40 rural hospitals, 139 RHCs, 304 long-term care facilities, and 4 substance-abuse treatment centers.
Listeners are walked through procurement and cost models (tiered connection costs with most expenses contractual), the required tie-ins with parallel investments (EHR expansion at $44.88M and data & analytics expansion at $21.7M), and the sustainability gamble: a five-year grant runway followed by a provider-assumed maintenance payment model beginning Q4 FY2031. Key milestones and timeline are called out — launch of connection subsidies in Q3 FY2026, a regional ingestion pilot by Q2 FY2027, peer portal by Q4 FY2027, full statewide availability by Q1 FY2029, and the transition to provider payments in FY2031.
The episode highlights measurable targets and performance metrics — 50% RHC HIE penetration by years 4–5, at least a 15% relative reduction in duplicate testing, and 100% county-level access to imaging/public health/mortality feeds by year five — and flags the highest risks: failure to demonstrate ROI to providers before the billing transition, procurement delays for critical infrastructure (the DICOM server), challenges in deploying a trusted behavioral-health consent app, and the need for flawless coordination with the EHR expansion. It closes by connecting these technical and policy elements to the everyday impact for rural Oklahomans: fewer duplicate tests, faster transitions of care, stronger data for value-based payment and population health, and reduced administrative burden for rural clinicians.
Listeners are invited to join the Oklahoma Rise 25 in 25 RHTP Task Force at Rise25in25.org or email info@rise25in25.org for more information.The Oklahoma Rise 25 and 25 RHTP Forum is produced and directed by Dr. Keley John Booth, MD.