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The Targeted Technical Assistance for Rural Hospitals Program (TTAP) is not a grant program for hospitals. Instead, participating hospitals receive technical assistance at no cost. All applicants are eligible to participate in webinars and training events focused on best practices for financial and operational improvement held throughout the grant period.


Program Purpose

The Targeted Technical Assistance for Rural Hospitals Program (TTAP) is a federally-funded initiative that offers comprehensive technical assistance to rural hospitals to address financial and operational challenges and maintain essential health services for their communities.

Over two years, selected hospitals are supported through a systematic and evidence-based process for identifying, prioritizing, and implementing short-term, mid-range, and long-term strategies for positioning their organizations for financial sustainability. There is up to an additional year of follow-up for monitoring and evaluation purposes. During their tenure in the program, hospitals receive comprehensive technical assistance in financial and operational assessment, financial sustainability planning, strategy implementation, monitoring, and evaluation.

Based on prioritized strategic needs, participants may receive tailored one-on-one technical assistance
during the implementation phase from experienced consultants and subject matter experts in one or more
of the following areas:


  1. Evidence-based Strategy & Business Development

  2. Service Line Evaluation & Reorganization

  3. Revenue Cycle Optimization

  4. Cost Reporting

  5. Clinical & Operational Quality Improvement

  6. Telehealth

  7. Rural Health Clinic Performance Optimization

  8. Marketing, Community Engagement & Outreach

  9. Workforce Engagement & Retention

  10. Coaching & Leadership Development

  11. Financial & Operational Management Education
    and Training


Eligible rural hospitals, including Critical Access Hospitals and Inpatient Prospective Payment System (PPS) facilities, can apply to participate in TTAP. Priority will be given to hospitals with greatest demonstrated need for TA and readiness to engage in in-depth technical assistance.

Eligible rural hospital: short-term, non-federal general facilities located outside Metropolitan Core-Based Statistical Areas (CBSAs) or located within Metropolitan areas in locations with Rural-Urban Commuting Area (RUCA) codes of four (4) or greater, or facilities in any location participating in Medicare as Critical Access Hospitals (CAHs). Hospitals operated by tribes and tribal organizations under the Indian Self-Determination and Education Assistance Act (Public Law 93-638, as amended) may also receive technical assistance.

Applicants must be: committed to fully engaging in TTAP programming; and must not be a current participant in the Delta Region Community Health Systems Development Program, the Rural Healthcare Provider Transition Project (RHPTP), or any other technical assistance program that is duplicative in services.


Who is not eligible?

Applicants not meeting the eligibility requirements listed above are ineligible to participate in this program. In addition, applicant organizations that are in the process of converting or have converted under the Rural Emergency Hospital (REH) designation are ineligible to participate.

The Ideal Candidate
The ideal applicant organization is a rural hospital or critical access hospital that demonstrates a need and readiness for targeted technical assistance aimed at supporting financial and operational stability. Participating hospitals must be committed to meaningfully engaging in all aspects of the program. While all eligible rural hospitals and critical access hospitals are encouraged to apply, this program is designed to best support organizations that are:

  1. not currently or have not previously received similar technical assistance; and

  2. do not have readily available access to resources to support financial and operational viability.

Application Process

Eligible critical access hospitals and PPS rural hospitals are invited to complete a brief application via the program website. The information collected in the application will be used solely to inform processes for selecting and providing technical assistance to rural hospitals. The application should take approximately 10–15 minutes to complete and does not need to be completed in one sitting. It can be saved and revisited within a 30-day period.

Online applications will be accepted on a rolling basis. However, an annual application deadline is announced for each new project year. The deadline for the 2023-2024 project year is Wednesday, February 7, 2024, at 11:59 pm. Once the application deadline has passed, organizations may begin applying for participation in the next project year. Applicants who are not selected may be considered for future cohorts.

Hospitals that submit an online application are required to participate in an approximately one-hour virtual interview with members of the TTAP team in February. Interview questions will focus on obtaining additional context and assessing organizational commitment and readiness to participate in technical assistance activities, leadership and board buy-in, and the availability of organizational resources to meaningfully participate in the program. Interview questions will be provided to applicant hospital organizations ahead of the interviews.

Selected organizations will be notified by the end of February, with technical assistance activities expected to begin in March. Cohorts of 4-6 rural hospitals will be enrolled annually. Each cohort will participate in the program for 2 years with an additional year of follow-up.

All applicants, regardless of whether they are selected or not, are eligible to participate in webinars and training events focused on best practices for financial and operational improvement. Additionally, applicants are eligible to receive selected benchmarked financial and operational assessment reports.

Please note that the annual enrollment of each grant cohort for TTAP-focused technical assistance is contingent upon funding approval for each project year.



All applicants will be scored on a rubric that assesses organizational need and readiness to actively participate in technical assistance activities. Each application will be assigned an overall recommendation based on the scores: Strongly Recommend, Recommend, Recommend with Limitations, and Do Not Recommend.

Four to six organizations will be selected annually and recommended to the Federal Office of Rural Health Policy (FORHP) TTAP program coordinator for final approval. In addition to the application, interviews, scores, and overall recommendation, other variables may be considered in the selection process.

System Affiliation: Organizations affiliated with a system tend to have more support and resources than non-system affiliated organizations. Where this is the case, preference may be given to non-system affiliated rural hospitals or critical access hospitals.


Why Participate?
Participating hospitals receive support to:

  • Optimize operational efficiencies.

  • Improve financial performance.

  • Improve clinical performance.

  • Develop sustainable, evidence-based solutions for maintaining essential health services.

  • Engage with healthcare management consultants and subject matter experts at no cost to the organization.

  • Enhance stakeholder (community, provider, and employee) engagement.

  • Establish community-centered partnerships for organizational and community viability.



Online application closes on February 7, 2024. All applicants are eligible to receive selected benchmarked operational and financial performance assessment reports and participate in webinars and training events held throughout the program period.


Virtual interview with hospital leadership occurs in February 2024.


Applicants will be scored on a rubric that factors in need and readiness to engage in TA activities. Selected hospitals will be notified via email in late-February.

Financial Assessment

TA activities are expected to commence in March, beginning with a comprehensive financial and operation assessment conducted between March and July 2024.

Financial Sustainability Planning

In-person financial sustainability planning sessions will be held between June and August 2024 with participating hospitals to identify and prioritize top strategies for financial sustainability and growth.

Consultant Matching

Based on identified priorities in step 4, hospitals will be matched with subject matter experts or consultants, factoring in expertise and knowledge of the geographic market. Matching will occur by September 2024


Hospitals will receive tailored one-on-one technical assistance from experienced consultants and subject matter experts to execute their prioritized strategies for financial sustainability. The implementation phase is expected to occur between September 2024 and August 2025.

Monitoring & Evaluation

Hospitals will be monitored for 12–15 months following implementation to ensure optimal implementation of prioritized strategies. Data will be collected and analyzed to assess the impact of TA activities and implemented strategies on improving hospital financial and operational performance.



Let’s Work Together

Center for Public Health Practice and Research

Jiann-Ping Hsu College of Public Health


Georgia Southern University

Hendricks Hall

501 Forest Drive

Statesboro, GA, 30461

(912) 478-2581

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