How Wyoming Pharmacies Can Access Rural Health Transformation Program 4.2 Funding for Clinically-Integrated Care Coordination

The Rural Health Transformation Program (RHTP) is a $50 billion federal initiative that sends funds to the states to help address rural healthcare gaps from 2026 to 2030. Each state decides how that money gets used: they identify their own gaps, build programs around those needs, and issue Requests for Proposals (RFPs) that local pharmacies and healthcare organizations can apply for directly. This is a historic opportunity for your pharmacy to expand your scope of practice, deliver life-changing clinical care, and serve the community that relies on you most.

In this ongoing blog series, we are tracking these playbooks state-by-state, breaking down exactly what your state is prioritizing and what infrastructure you need to get grant-ready.

Wyoming RHTP 4.2: Clinically-Integrated Care Coordination
Who can apply: Wyoming-based pharmacies and healthcare organizations
Funding Available: $ 2.9 million
Application Deadline: August 2nd 2026
Apply directly here: wyrhtp.submittable.com/submit/359035/4-2-clinically-integrated-care-coordination

Wyoming, often described as a "small town with unusually long streets," has 74% of its population living in rural or frontier areas. As the most sparsely populated state in the lower 48, these vast distances create significant barriers for patients managing chronic conditions. Patients often have to manage complex care regimens from hours away, leaving them vulnerable to unmonitored health issues that can escalate between appointments.

The hospital, pharmacy, primary care provider, and remote-monitoring team are all supporting that patient. But too often, the systems they use do not connect and talk to each other. That creates an opportunity for better coordination.

Who Is Eligible for Wyoming RHTP 4.2?

Eligibility for Initiative 4.2 is broad but requires a few key elements:

• Wyoming presence: The lead applicant must be based in Wyoming. Out-of-state organizations cannot apply without a qualifying in-state partner.
• Provider fit: The program is designed for healthcare providers delivering coordinated care in rural settings. Pharmacies are well-positioned to participate given their role in medication management, chronic disease support, and patient engagement. They can partner with a local care clinic, hospital, Federally Qualified Health Centers (FQHC), physician practice, or another healthcare organization to create a shared patient-care workflow.
• Attestations and eligibility form: Applicants must complete required attestations and submit the separate 0.1 Applicant Eligibility Information form, including SAM.gov registration and EIN-linked documentation.
• Lead organization and coalition: Proposals must identify a lead organization and include a multi-provider coalition. Pharmacies can lead or participate as medication-management partners.

Wyoming is prioritizing models that bring providers together, use frontline health workers, leverage technology, and keep care local. Pharmacy-led or pharmacy-inclusive models that show these elements are well aligned with the state's goals.

Applicants should also show how the care-coordination model can continue after the initial funding period. Wyoming's broader sustainability plan expects applicants to explain how future provider revenue will support ongoing operating and maintenance costs.

What Is Wyoming RHTP 4.2 and How Does it Work?

Initiative 4.2 is part of Wyoming's broader Make Wyoming Healthy Again initiative, a subset of Wyoming's overall Rural Health Transformation Program.

Wyoming's Initiative 4.2 supports care coordination for high-risk patients enrolled in both Medicare and Medicaid who are managing chronic conditions. For pharmacies, it is an opportunity to help patients manage medications, stay connected to care and receive support between appointments.

This initiative is structured differently from a traditional grant. Here's what the opportunity looks like:

1. Wyoming identifies high-risk patients. The state will use Medicaid claims data to identify eligible patients, and randomly assign them to a treatment group or a control group.
2. Care teams assemble and apply to participate in Initiative 4.2. They must demonstrate how their care model will help patients better manage chronic conditions, stay connected to care, and avoid unnecessary emergency department visits or hospital stays.
3. Wyoming reviews applications and selects the strongest care model for each county or region. The state is prioritizing proposals that bring providers together, use frontline health workers and leverage technology to deliver care closer to home.
4. Winning teams are selected to become the lead care-coordination team for their approved Wyoming county or region. The successful applicant receives the randomized treatment-group patient list and begins delivering care. They are responsible for reaching patients, assessing their needs, coordinating with other providers, following their progress, and documenting their care delivered.
5. The team coordinates care and documents interventions. For a pharmacy, this can include medication reviews, post-discharge follow-up, adherence support, chronic-disease check-ins, patient outreach, and communication with the patient's broader care team.
6. Wyoming evaluates the care given to the treatment and control group, whether the treatment group of patients experience less avoidable hospital care and lower healthcare cost than the control group. They compare the groups using claims-based healthcare utilization and cost measures. This happens at the end of each award year.

How Will Winning Applicants Be Paid?

Wyoming's Initiative 4.2 uses a blended payment model designed to help organizations launch care-coordination programs, support patients over time, and reward meaningful improvements in outcomes.

Rather than relying on a single funding stream, successful applicants receive payment in three ways: start-up funding, a recurring monthly payment for each assigned patient, and shared savings if the program improves outcomes and lowers avoidable healthcare costs.

Start-Up Funding

Winning applicants receive an initial, one-time payment to help establish their care-coordination program. This funding is intended to offset the upfront costs required to get the model operational.

Typical uses include:

• Hiring or training staff
• Purchasing equipment or technology
• Establishing workflows and partnerships
• Building outreach and documentation systems

While Wyoming has not published a fixed cap for this funding, it is intended to help organizations launch the program without carrying all of the initial costs themselves.

Per-Member-Per-Month (PMPM) Payments

Once the program is active, Wyoming proposes paying a recurring monthly fee for each patient assigned to the treatment group.

This PMPM payment supports the day-to-day work of care coordination, including:

• Patient outreach and engagement
• Medication reviews and risk identification
• Chronic disease monitoring
• Coordination with providers and care teams
• Follow-up and adherence support

This payment is not tied to individual services or visits. Instead, supports the ongoing responsibility of managing and coordinating care for a group of high-risk patients over time.

Shared Savings

In addition to start-up and monthly payments, Wyoming may reward organizations that demonstrate measurable improvements in healthcare utilization and cost.

At the end of each award year (based on the RFA award dates) the state will compare:

• The treatment group (patients receiving care coordination)
• The control group (similar patients not receiving the program)

If the treatment group shows lower healthcare costs or fewer emergency department visits or hospitalizations, the organization may receive a portion of those savings. This shared-savings component is designed to reward strong care-coordination strategies and align financial success with better patient outcomes.

What Clinical Infrastructure Do Pharmacies Need to Support Initiative 4.2?

Initiative 4.2 gives applicants the flexibility to propose their own care-coordination model. Your application needs to show how you will manage an assigned patient group, reach patients, deliver care, coordinate with providers, maintain follow-up, and document your work.

A traditional pharmacy management system is built primarily for dispensing. A care-coordination program may also require clinical scheduling, structured documentation, patient outreach, longitudinal care plans, provider communication, and reporting workflows.

MedMe works alongside the pharmacy's existing PMS as the clinical layer that enables these workflows.

Care Coordination Readiness: MedMe vs. Traditional PMS

Before writing your application, review the Initiative 4.2 requirements in the full project narrative PDF

Apply here: wyrhtp.submittable.com/submit/359035/4-2-clinically-integrated-care-coordination