DSS Shares RHTP Community Hub Boundaries, Opens Hub Anchor Applications
The Missouri Department of Social Services on May 15 released the county groupings that will define the community “Hubs” under the state’s Rural Health Transformation Program, known as ToRCH Care, which is part of a $50 billion federal initiative established in July 2025.
The 27 Hub groupings — each consisting of about two to six counties — reflect extensive stakeholder input and are intended to align with how care is already delivered in local markets. A map of the Hub groupings is available on the DSS website.
In addition to the boundary announcement, DSS opened a Request for Applications (RFA) for organizations to serve as Hub Anchors. Applications are due by 11:59 p.m. Thursday, June 18, and must be submitted to DSS.RHTP@dss.mo.gov.
Interested applicants are encouraged to register for a webinar about the Hub Anchor application process, scheduled from 11 a.m. to 12:30 p.m. Tuesday, May 19.
These community Hubs are central to the state’s effort to redesign rural health care by organizing providers and community partners into coordinated, multicounty regions that can better align services and address local health needs. Each Hub will bring together hospitals, clinics, EMS, pharmacies and community-based organizations to improve access, strengthen care coordination and address local population health needs.
A designated Hub Anchor will serve as the neutral convener, responsible for coordinating partners, supporting governance, and ensuring effective clinical and social service integration across the region.
For hospitals, this represents a key strategic opportunity to shape regional care delivery. DSS is encouraging collaborative, consortium-based approaches. Early engagement will be critical as organizations determine whether to pursue an Anchor role or participate as a key partner.
About the Rural Health Transformation Program
The Rural Health Transformation Program, created under the One Big Beautiful Bill Act (OBBBA), is a landmark federal initiative to strengthen rural Americans' health care access and outcomes through sustainability and innovation. Beginning in 2026, the program provides $50 billion over five years, divided equally between state-distributed funds and competitive grants to states awarded by the Centers for Medicare & Medicaid Services (CMS). Missouri's state-led initiative, known as Transformation of Rural Community Health (ToRCH Care) and coordinated by the MO HealthNet Division within the Missouri Department of Social Services, received a $216 million award from CMS for the first year of the program. ToRCH Care is expected to build local partnerships, expand care coordination and build capacity through a “community hub” model. Rural hospitals, clinics and provider networks are expected to be the primary recipients of these funds. These investments are especially critical as hospitals face future reductions in Medicaid state-directed payments and provider tax matching rates, which disproportionately impact rural hospitals.
The Missouri Hospital Association is a nonprofit association in Jefferson City that represents 136 Missouri hospitals. In addition to representation and advocacy on behalf of its membership, the association offers continuing education programs on current health care topics and seeks to educate the public about health care issues.