Series
State Implementation Analysis
The constraints that determine RHTP implementation success are not randomly distributed. They cluster around Medicaid expansion status, lead agency authority structure, rural population scale, per-capita allocation, and the ratio between federal investment and concurrent Medicaid cuts. This series maps those constraints across all fifty states, identifies the failure modes tied to specific constraint profiles, and assesses which transformation approaches fit which conditions.
RHTP-03.PRE
The Case for Cross-Cutting Intelligence
State directors already know their own situation. What no single state can see from inside its own implementation is the pattern that only scale reveals: which approaches fail …
RHTP-03.01
RHTP Inside HR1
Every state RHTP director has read Section 5601. Almost none have read the other 1,050 pages with the same care. The same legislation that funds transformation also restructures …
RHTP-03.02
Constraint Clusters
A non-expansion Deep South state learns more from other Cluster 4 states facing coverage-gap sustainability problems than from a small New England state with six times the …
RHTP-03.03
Medicaid Math by State
Wyoming faces $0.2 billion in Medicaid cuts against a $1.02 billion RHTP award. California faces $149.8 billion against $1.17 billion. Pennsylvania's 47:1 ratio is driven by …
RHTP-03.04
Implementation Risk Patterns
Generic risk frameworks flag procurement delays for every state with a large rural population. That is documentation, not intelligence. The six failure modes here are structural: …
RHTP-03.05
Approach Fit and Timeline
Telehealth has strong evidence. It has weak evidence in communities with 40 percent rural broadband coverage because the research was conducted in communities with broadband. A CHW …
RHTP-03.TD1
50-State Constraint Reference
Document Purpose
The complete 50-state data foundation: RHTP award, per-capita allocation, Medicaid cut projection, ratio, expansion status, authority gap, primary cut mechanism, and 2026 …
RHTP-03.TD2
Medicaid Cut Projections
Document Overview
State-by-state Medicaid cut projections from KFF's allocation of CBO's $911 billion estimate, with confidence ranges at approximately plus or minus 25 percent. Wyoming is the only …
RHTP-03.TD3
Provision Composition by State
Document Overview
The ratio shows how much each state loses. Provision composition shows why the same loss lands differently. Indiana's 18.8:1 is 44 percent provider tax: rate compression on …