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.