What Tech Vendors Got Wrong in RHTP Year 1…and What to Fix for Year 2

CMS is announcing Y2 RHTP awards…making it a great time to share the patterns I’m seeing among tech vendors and some of the lessons they’re learning from Y1. 

“We didn’t know the program existed and now have to catchup.”

I’ve run across a couple of vendors who were caught flatfooted when they realized their customers and prospects could be directly impacted by Rural Health Transformation. 

Lesson: You either need someone who owns the program, or a relationship with a consultant or vendor who will flag opportunities like this for your team. I’ve done it for more than one client whose leadership was too busy to keep an eye on all the changes going on in the federal government. 

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“We tried targeting all the states and won none.”

RHTP is all about state-specificity and the complexity is leaving many tech vendors across the country confused as to why their outreach isn’t working. 

This isn’t a standard healthcare buying committee play, and just getting in front of state leadership won’t likely get you anywhere.

Multi-track procurement means your team needs extreme accuracy in sorting the four levels of potential buying influence: 

• The state itself
• Provider sub-recipients (grant funded)
• Networks and shared-service entities (hubs) 
• Intermediaries that are running initiatives for the state 

Lesson: Going into Y2, I still recommend starting with a handful of highly targeted states (preferably where you already have a presence) and working from there. Start with this exercise if you don’t yet have a shortlist. 

“We had no response to their RHTP questions.”

Your customers, prospects, and conference planners are engaging RHTP…and they’re looking to their vendors to provide insight and guidance on the technology transformation piece. 

I’ve run across multiple vendors whose leadership and sales reps are fielding questions without prepared responses. That wasn’t a big deal in Y1, but going into Y2, your competition is ready with clear narratives and ideas for conference presentations. 

Lesson: Know your stance on transformation early and have it prepared in sales and marketing materials. Your messaging should be clear at this point and conversations around how you support state stakeholders should be uniform and smooth. If this isn’t the case, consider the Sales Enablement Foundations here. 

“Leadership doesn’t get it.”

I’m hearing this more from sales reps who know the market is moving in this direction, but their leadership is focused elsewhere. 

The missing piece is usually pretty simple: A brief that explains the opportunity as well as why current customers, prospects, and competitors are already moving. Leadership needs to see RHTP as aligned with their current business goals…and that’s the case I help teams build after a quick 15-minute call. (No charge for the brief)

“We’re still waiting for it to make sense.”

Y2 is probably the last chance to get a decent start in the program as a tech vendor. Grant windows are short and the program only runs five years. CMS also discourages major change across program years so by the end of 2027 you’ll be running out of runway. 

Lesson: Even if you just want to do your due-diligence for when the Medicaid cuts start to hit (and show up as reasons your team is losing customers and prospects), now is the time to start. A short brief (comes with an intro call with me) on the program will often be enough to prove you asked the right questions at the right time. 

“We’re a no brainer for rural.” 

“If you build it, they will come” doesn’t work for RHTP. 

Buyers are extremely busy and still learning the program themselves. Most of the most influential aren’t even aware of your solution, especially in the context of how it enables transformation. Even perfect-fit solutions should be doing outreach.  

Prediction #1: “We lost a big urban client because a competitor used RHTP as a back door”

Most states understand the relationship between rural and urban and have built it into their programs. Vendors are getting great exposure to non-rural buying committee members, so I’m expecting a future where tech vendors start to see impact to their customers and prospects, even outside RHTP.

Prediction #2: “The Medicaid cuts are showing up in win-loss conversations”

The $1 trillion in Medicaid cuts started in October 2026 and are only getting more intense from here. I fully expect scrambling once the full knock-on impacts start to emerge. (Here’s a timeline through 2028.)

RHTP is picking up serious momentum, but is still in play for new entrants. Grab some time on my calendar before 2027 if you’d like some help getting steered in the right direction.