Oklahoma puts data at the forefront of its rural health improvement strategy

Nearly a year after the Rural Health Transformation Program’s launch, state lawmakers are still scrambling to meet demanding implementation and reporting requirements as they try to enhance rural healthcare speedily and sustainably. 

Over the next five years, states will receive a share of $50 billion through the federal Rural Health Transformation Program, which aims to support improvements to and the maintenance of rural healthcare services and programs. Several states, for instance, have declared that they will prioritize funds to enhance data infrastructure, telemedicine and other deliverables. 

But states have faced an “abbreviated first year to do their work” since the first round of funding was not allocated until January, despite the program’s September 2025 launch, said Carrie Cochran-McClain, chief policy officer at the National Rural Health Association, during a panel session at the National Conference of State Legislatures 2026 Legislative Summit in Chicago last week.

At the end of August states will be required to submit their first annual progress reports to the Centers for Medicare and Medicaid. Those reports will undergo evaluation between September and October for the federal government to determine funding allocations for the program’s second year. 

“This is a big deal; [it] is because both the way the federal statute was written and the way CMS has interpreted that in the planning program, states — while they have written their five-year application and plan — may have changes in their funding levels for future years, and maybe even in year one, depending on how much progress they've made towards their goals,” Cochran-McClain said. 

States are “laser-focused right now in getting as much money as they can out the door,” particularly as the threat of funding clawbacks or changing resource levels increasingly looms, she said.

Oklahoma, for instance, is pouring its first-year allocation of $223 million RHTP funds into six initiatives: innovating healthcare delivery models; supporting community-led health initiatives; facilitating collaboration among healthcare providers and partners; implementing value-based care; developing the healthcare workforce and building health data coordination across the state.

But measuring the implementation and impact of those initiatives for future program work could prove difficult without stronger data reporting mechanisms, David Crall, legislative analyst for the Oklahoma Legislature, told Route Fifty. 

“Right now, we really have fragmented data. It's a problem,” he said. “We've historically not been very good at it, and the pandemic really exposed the flaws in our data collection, and the lack of maintenance and investment in our public health data infrastructure in particular.” 

That’s why one of Oklahoma’s “big initiatives” includes “bolstering its [health information exchange] because there's a lot of data in that, and it can connect hospital systems and all the state's electronic health record systems,” Crall explained. 

The state launched the Oklahoma State Health Information Network and Exchange — or OKSHINE — in 2023, but its enforcement drew pushback from several healthcare providers at the time, who voiced concerns about patient privacy and implementation costs.

The RHTP can enable the state to offer healthcare providers additional financial and technical assistance for connecting to OKSHINE, fulfilling Oklahoma’s broader goal of enhancing rural health data insights across healthcare settings and programs, Crall said during the panel session.

The Oklahoma Healthcare Authority, for instance, has allocated $6.2 million under the RHTP to subsidize connection and onboarding for OKSHINE and another $8.2 million to develop advanced solutions, like AI-enabled analytics, and other resources like data dashboards to better identify and address rural health, care gaps and outcomes, he said. 

In the long term, the HIE can offer officials one way to track and monitor the state’s progress under the federal program “and give us aggregated [data] that will show us where our needs are” to further inform ongoing rural health interventions, Crall told Route Fifty. 

Additionally, “I think something that would be critical to success that we've seen in other states is an all-payer claims database,” he said. Such databases, which generally serve as a central system that collects data from public and private health insurance claims, “could take that fragmented data and actually help us make sense of it and get a full picture [of rural public health] instead of looking at part of the picture,” Crall explained. 

Ultimately, as states like Oklahoma press forward with their implementation and reporting of RHTP, “we're going to be really building the plane as we fly it,” Crall said.