Milliman CareFlowIQ
Traceable Data for Rural Health Transformation
Milliman CareFlowIQ helps connect the clinical, claims and program data behind your state’s Rural Health Transformation Program (RHTP) initiatives, so you can measure progress and support defensible reporting.
RHTP at a Glance
The Rural Health Transformation Program is a Centers for Medicare & Medicaid Services (CMS) program that funds state-led initiatives to strengthen rural health care.
- $50 billion over five years, with an award to every state. Source: CMS, December 2025
- First-year state awards average $200 million, within a range of $147 million to $281 million. Source: CMS, December 2025
- CMS organizes the program around five goals, including tech innovation. Source: CMS, September 2025
- States must carry out activities in at least three use-of-funds categories, and IT advances is one of them. Source: CMS Rural Health Transformation Program
What Data Does RHTP Measurement Depend On?
RHTP measurement depends on clinical, claims, health information exchange (HIE) and program data that can be connected and traced back to its source.
That data sits in electronic health records (EHRs), claims systems, HIEs and program feeds that were not built to be read together. States are also working on a fixed timeline with limited operating capacity.
Milliman CareFlowIQ:
- Connects data from the sources you already have
- Applies a clinically meaningful model
- Organizes it into one searchable picture, from population to patient
Connection still takes scoped work, and what you see reflects the data available.
What Makes CareFlowIQ Different for RHTP Programs?
Built for programs that have to deliver and prove impact on a fixed timeline.
Connect Any Source
Bring EHR, claims, HIE and program data into one model without requiring a particular vendor stack or data model first.
Make Cohorts Auditable
Define the populations each initiative serves with configured, clinically grouped logic, then trace every cohort back to its source.
Cut Reporting Burden
Produce configured, traceable reports from connected data, so staff can spend more time acting on the data.
Defend the Investment
Show progress with modeled cost and utilization insight, built on Milliman risk models, with the assumptions in plain view. Results are modeled opportunity, not guaranteed savings.
From Rural Population to Patient Story
Milliman CareFlowIQ turns fragmented data into a connected Whole Patient View™ that moves from population to cohort to individual patient in one record. Program leaders see where to focus. Clinicians see the story behind each number. The view reflects the data available.
Clean, Traceable Data for Rural Health Programs
Auditable Cohort Identification
Source-Agnostic Data Connection
Quality and Care Gap Measurement
Reporting Burden Relief
Modeled Cost and Utilization Insight
Documented Data Provenance
How Does a Phased RHTP Rollout Work?
CareFlowIQ runs in three connected phases, Connect, Activate and Expand, so a statewide program builds on one data foundation and widens at its own pace without re-platforming.
RHTP initiatives are state-led and federally visible. CareFlowIQ works alongside states, HIEs, conveners and awardee partners, adding clinical meaning, traceable cohorts and program-level reporting. Scope is defined with your state partner.
- Connect: establish the data foundation. Connect FHIR, HIE and EHR sources and ingest claims and clinical data through secure, read-only integration. Integration effort depends on the data your partners can provide.
- Activate: create the Whole Patient View™. Build a Whole Patient View across sources, apply risk stratification and segmentation, and stand up initial dashboards and decision support.
- Expand: widen cohorts and use cases. Add cohorts and use cases across providers and regions, track outcomes against configured measures at the program level, and adjust as measurement needs change. The foundation keeps working after a single funding cycle ends.
Which Rural Cohorts Need Attention First?
Risk stratification and segmentation show which rural cohorts carry the most modeled risk, so program teams can decide where to act first.
CareFlowIQ includes risk analysis tools built on Milliman risk models, including customizable models such as Milliman Advanced Risk Adjusters (MARA). Program teams can segment the population, see which rural cohorts to prioritize and track those cohorts over time. Risk scores are modeled estimates that inform program decisions, not guarantees of results.
Frequently Asked Questions
The Rural Health Transformation Program is a Centers for Medicare & Medicaid Services (CMS) program that commits $50 billion over five years to strengthen rural health care, with an award to every state. Each state sets its own initiatives and measures.
CMS asked states to identify at least four quantifiable metrics for each initiative, including at least one at county or community level. Meeting that depends on clinical, claims, health information exchange (HIE) and program data that can be connected and traced to its source.
No. CareFlowIQ works with the data and systems your partners already use. CMS guidance also caps EMR replacement at 5 percent of total funding when a HITECH-certified EMR was already in place on September 1, 2025. Check your state’s plan for its own rules.
Partners keep the relationship with the state. CareFlowIQ adds clinical meaning, traceable cohorts and configured reporting on top of the data they move, in a clearly scoped, phased plan your state partner can approve. Funding and contracting follow your state’s program and procurement rules.
No. CareFlowIQ helps produce traceable, configured reporting from connected data. Your state defines the measures and the reporting obligations.
Work starts with a scope defined around your program’s population, data sources and phases, beginning with Connect. Integration effort depends on the data your partners can provide, and we define it with you up front.
CareFlowIQ is built for secure, traceable data handling. Data is encrypted, access-controlled and traceable to its original source. Ask us for current compliance documentation.
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Defensible Measurement for Rural Health Transformation
See how CareFlowIQ can help your program connect its data, trace its cohorts and report with confidence.
