Rural Access to Primary and Preventive Services (RAPPS) Program

The Rural Access to Primary and Preventive Services program is one of four directed payment programs HHSC has submitted for CMS approval as part of the Delivery System Reform Incentive Payment Transition Plan. The proposed start date is September 1, 2021.


RAPPS is a directed payment program for rural health clinics (RHCs) that provide primary and preventative care services to STAR, STAR+PLUS, and STAR Kids members.

The program would include two components:

  • Component 1 would provide a uniform dollar increase in the form of prospective, monthly payments to all participating RHCs to enhance structures that promote better access to primary and preventive services.

    The amount of the increase would vary by RHC class. The structure measures would include reporting on electronic health record use, telemedicine/ telehealth capabilities, and ensuring access to care for Medicaid clients.
  • Component 2 would be a uniform percent rate increase for certain services based on achievement of quality metrics focused on preventive care and screening and management of chronic conditions.

Proposed Year 2 Metrics and Associated Reporting Requirements

HHSC will conduct a public hearing on January 11, 2022, beginning at 2:00 p.m. CST, to review proposed measures and reporting requirements for year 2 of the Rural Access to Primary and Preventive Services (RAPPS) program. Please note that RAPPS program year 1 is pending Centers for Medicare & Medicaid Services (CMS) approval.

Additional information on the hearing is available on the HHS Events Page.

Due to the COVID-19 pandemic, this hearing will be conducted online only. There is not a physical location for this hearing. Please register for the hearing here.

Briefing Packet:

Proposed Program Year 1 Rules and Requirements

Contact Information


DPP Contact Change Form (PDF)