Transforming Rural Health

Maine’s rural communities face a growing crisis in meeting the health care needs of their residents. Over the past decade, many rural communities have experienced an erosion of fundamental health services, growing financial threats to their hospitals, and challenges to sustaining their health workforce. These forces have collectively resulted in serious threats to the economic, physical, and behavioral health of rural residents, and the time for action is now. The limitations of current payment structures and rules will require us to develop new approaches and creative ways to organize, finance, and deliver rural health services to create a sustainable and high-performing rural health system that better meets the needs of Maine’s rural residents.

Through the rural health transformation initiative, DHHS seeks to improve the health care and health outcomes of our rural communities by leading a bold, innovative, and collaborative effort to transform rural health and health care services that leverages the state’s assets to provide care for rural populations.

Events and Meeting Minutes

Rural Health Transformation Team Meetings
Meeting Date Documents
April 2, 2020 Agenda (Word)
January 9, 2020 Agenda (Word)
Understanding Trends in Telehealth Utilization - presentation (PDF)
October 3, 2019 Agenda (PDF)
July 11, 2019 Agenda (Word)
Meeting Summary (PDF)
ME DHHS Rural Health Transformation Framework (PDF)


Rural Health Listening Sessions
Date Location Documents
January 14, 2020 Skowhegan Invite (PDF)
October 29, 2019 Bethel Invite (PDF) Meeting Report (PDF)
September 30, 2019 Lincoln Invite (PDF) Meeting Report (PDF)
September 10, 2019 Farmington Invite (PDF) Meeting Report (PDF)
August 29, 2019 Calais Invite (PDF) Meeting Report (PDF)
August 12, 2019 Caribou Invite (PDF) Meeting Report (PDF)


Publications, Materials, and Presentations

Resource Material 

Primary Care

Centers for Medicare & Medicaid Innovation (CMMI) Primary Care First Program (website) (slides) - Primary Care First Model Options is a set of voluntary five-year payment options that reward value and quality by offering an innovative payment structure to support delivery of advanced primary care.


Telehealth in Maine (PDF) - A brief update on current gaps and emerging initiatives.

Northeast Telehealth Resource Center (NETRC)

NETRC Maine Resources

MaineCare Telehealth Guidance in COVID-19 Emergency Period (PDF)


Pennsylvania Rural Health Model – This model is a state-led initiative developed in partnership with CMMI to design an alternative payment model for rural hospitals in Pennsylvania.

Colorado Hospital Transformation Program Concept Paper – This Concept Paper describes Colorado's transition to a value-based program.

Ensuring Access to Care in Vulnerable Communities. - The task force report outlines nine emerging strategies that can help preserve access to health care services in vulnerable communities.

Life in America Parts 1 & 2 - The “Life in Rural America” polling series is based on a survey conducted for National Public Radio, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

The Life in Rural America – Part I survey was conducted June 6 – August 4, 2018, among a nationally representative, probability-based telephone (cell and landline) sample of 1,300 adults ages 18 or older living in the rural United States. The purpose of this survey was to understand the current views and experiences of rural Americans on economic and health issues.

The Life in Rural America—Part II survey covers rural Americans’ personal experiences with health, social, civic, and economic issues in their local communities. It was conducted January 31 – March 2, 2019, among a nationally representative, probability-based telephone (cell and landline) sample of 1,405 adults ages 18 or older living in the rural United States.

Opportunities to Advance Complex Care in Rural and Frontier Areas - This brief, made possible through the Robert Wood Johnson Foundation, explores challenges associated with providing complex care in rural and frontier communities and outlines opportunities to ensure effective programs.

Reinventing Rural Health Care: A Case Study of Seven Upper Midwest States - In 2017, the Bipartisan Policy Center and the Center for Outcomes Research and Education (CORE) spoke with over 90 national thought leaders and stakeholders about the current state of rural health care in the Upper Midwest region, including Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wyoming. BPC and CORE used these discussions to determine the real-world implications of existing federal policies, to understand ongoing care challenges, and to identify opportunities for improvement in rural health care access and delivery.

Strengthening Health and Health Care in Rural America - Developing and sustaining new ways for rural Americans to access health care should be a top priority, given high levels of need.

Supporting Rural Health: Practical Solutions for State Policymakers - In November and December 2018, the Fund conducted three RSG regional meetings. As part of those meetings, state health policy leaders from both the executive and legislative branches met with national experts to discuss rural health concerns and learn more about practical, actionable solutions to the most pressing issues.

Toward a High Performing Rural Health Care System - This paper summarizes the key themes and recommendations that emerged directly from the structured conversations during a two-day meeting convened by the Rural Policy Research Institute's Health Panel. The Health Panel hopes this summary can inform ongoing national and state policy discussions of strategies for strengthening and sustaining rural health care systems.