In this episode of the RHTP podcast hosts unpack the Primary Care Provider Clinical Extension Models — a five‑year, $37+ million initiative designed to solve the operational capacity crisis in rural primary care. We walk through the program’s strategic rationale, its high‑risk Medicaid and dual‑eligible focus, and why OHCA is the lead agency driving a plan explicitly tied to value‑based care performance.

The conversation explains what the clinical extension approach is — external, shared operational teams (care coordinators, health coaches, pharmacists, and technology platforms) that do proactive population health work without expanding practice payroll. We describe the three conceptual models: Primary Care As A Service (shared vendor teams), in‑home wraparound support for high‑need dual eligibles, and technology‑enabled remote monitoring with a human response layer.

Listeners get a clear roadmap of the phased rollout: administrative and design work in FY2026, a first cohort of 10 practices in FY2027–28, a pause for measurement and refinement, a second cohort in year four, and comprehensive outcome analysis by Q4 FY2030. We cover the required evidence standard — a risk‑adjusted total cost of care (TCOC) reduction target of 5–10% versus controls — and the technical challenges around attribution, risk adjustment, and robust measurement.

The episode outlines critical dependencies and risks: tight integration with EHR/HIE and practice enablement initiatives, vendor quality and rural expertise, rigorous practice selection, and—most importantly—managed care entities agreeing to transition to PMPM payments to sustain the model after RHDP funding phases down. We explain the staged financial transition (RHTP fully subsidizes early years, then scales down to force MCE buy‑in) and the governance role OHCA must play to coordinate vendors, data flow, and payer negotiations.

Finally, we tie the operational specifics back to the bigger stakes for Oklahoma: stabilizing fragile rural practices and critical access hospitals, improving clinical outcomes and community trust through wraparound care, and generating Oklahoma‑specific evidence to catalyze broader payer adoption. Expect concrete implementation milestones, realistic execution challenges, and a clear sense of what success will look like for patients, providers, and payers.

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.