Advocacy Correspondence: PA Department of Human Services Secretary, Rural Health Transformation Program

 September 5, 2025

The Honorable Valerie A. Arkoosh, MD, MPH
Secretary
Pennsylvania Department of Human Services
625 Forster Street
Harrisburg, PA 17120

Dear Secretary Arkoosh:

On behalf of The Hospital and Healthsystem Association of Pennsylvania (HAP) and our more than 235 member organizations statewide, please accept this proposal submission supporting HAP’s form submission on August 29.

As you know, HAP stands ready to support the development of the commonwealth’s application to the Rural Health Transformation Program (RHTP) to address the needs of rural Pennsylvanians and our communities.

Many of Pennsylvania’s rural hospitals and the services they provide are already at risk and this trajectory will only worsen as destabilizing Medicaid payment cuts take effect in the coming years. Understanding that the intent of the RHTP is to stabilize rural hospitals so they can sustainably serve their communities into the future, we are offering suggestions on investments that keep rural hospitals, and the services their communities depend on, open. We continue to caution against tying RHTP funds to new initiatives that cannot be sustainably maintained when the program ends and hospitals are left to absorb permanent payment cuts.

As the department continues developing Pennsylvania’s transformation plan, we respectfully urge consideration of the following key factors:

• Rural hospitals cannot care for our communities without a robust and highly trained workforce. RHTP investments can supercharge initiatives to develop, attract, and keep providers in our rural communities.

• Targeted financial support will help rural hospitals take action now to improve their future stability. Infrastructure improvements to modernize facilities and implement technology that supports innovations like telehealth and virtual nursing will help hospitals transform care delivery and streamline operations.

• Investments through the RHTP will only be successful in transforming rural health care if they’re combined with the necessary regulatory flexibility and updates that empower rural hospitals to innovate.

With these considerations in mind, please find attached HAP’s proposal, organized in a three-prong framework: Workforce, technology and infrastructure, and regulatory relief. We believe this framework presents cross-cutting opportunities to address all of the department’s priority areas (maternal health, behavioral health, aging, EMS, technology, and workforce).

We look forward to collaborating on this significant opportunity to provide a severely needed lifeline for the state’s rural hospitals so that they can continue to ensure access to high-quality care in their communities. Thank you for your continued leadership in support of the health of rural Pennsylvanians.

Sincerely,

Nicole Stallings
President and Chief Executive Officer

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Topics: Access to Care, Rural Health Care

Revision Date: 9/5/2025

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