What is the Rural Health Transformation Program?
The RHTP represents a once-in-a-generation $50 billion federal investment in local health infrastructure. States were advised to target a budget of $200M per year for 5 years per state. Awards were announced on December 29, 2025, with funding flowing from 2026 through 2030. Awards ranged from $147M in New Jersey to $281M in Texas.
Half of the funds were distributed equally by approved states, with the remaining half based on the size of the rural population, the proportion of rural health facilities, and the financial position of specific rural hospitals in that state. The timeline to begin spending is ambitious — states are already issuing Notices of Funding and Requests for Proposals to accomplish their strategic objectives.
Award amounts by state: CMS Press Release →
What Are CMS' Goals?
While CMS issued a set of high-level strategic goals, each state submitted unique proposals creating varied implementation approaches. Each state is setting up their own website to discuss specific implementation plans, issue their RFPs, and hold learning webinars — reinforcing a provider-first, community-first, locals-first approach.
How Should I Think About Participating and Why?
Mandatory Provider Partnership Structure: Many states are requiring on every RFP a provider lead who has experience in their rural populations with demonstrable outcomes, which vary depending on the pillar. While it is critical to incorporate local experience, population behaviors and needs, and community organizations, it places a substantial burden on providers already facing significant financial distress.
Most rural providers disproportionately rely on Medicaid payments, which have been cut in 2026. While this can be daunting, rural providers should not miss out on this incremental funding that supports their mission and communities.
What Not to Miss Out On?
Many state-specific RFPs are proposing new clinical models where providers will want to have a say on what is valuable at the provider and patient experience level, alleviating workforce burnout, and economically viable for them to sustain long-term.
Seize Capital Investment Opportunities
States are funding wraparound services including telehealth, consumer apps, and in-home visits around existing rural health clinics, supplementing current independent investment.
RHTP program funds support team-based care infrastructure enabling qualification for advanced payment models (APMs).
RHTP funding addresses pent-up demand in health provider shortage areas — primary care, behavioral health, maternity, dental — to increase patient attribution, capitation payments, and downstream revenue capture.
Participate in Workforce Transformation Initiatives
States plan to implement expanded scopes for pharmacists managing chronic illness, community health workers, CNA upskilling, dietitians, EMTs, and more.
Lower-risk populations supported through other provider types, digital health apps, and remote monitoring — letting PCPs focus on more complex patients.
Health systems must shape oversight protocols, staffing ratios, centralized documentation, and integration standards for new workforce roles.
Benefit from RHTP as an Innovation Lab
Required investment in chronic care management and maternity care platforms provides a testbed for clinical workflow integration.
Transition from episodic clinic visits to continuous population management with new technology roles and oversight structures.
Test consumer-facing technologies (remote patient monitoring, health education) under real-world conditions before broader CMMI deployment.
How National Players Can Help De-Risk Rural Health Systems
Given the broad CMS strategic goals and ambition of state RFPs, rural providers will not be able to take on this aggressive ecosystem building alone. It will be imperative for economic scale and speed to include national players with proven models and health outcomes. We do not have the health system bandwidth or finances to reinvent the wheel.
Large health systems, ACOs, Managed Care Organizations, Joint Ventures and others have been working on this collective ecosystem since the 1990s. The skill will be to wade through the outcomes-based effective models and connect them in an easier, plug-and-play, data-savvy way to rural providers.
💵 Upfront Capital
RHTP funds, when broken down to the clinic level, do not include enough for the scope of its ambitions. National players could contribute areas like EHR connectivity, device-agnostic chronic illness technology, program evaluation support, and population health talent.
🔗 Point-of-Care Innovation
Create a new opportunity to rethink how providers use population health data from multiple sources, make it applicable across programs, and efficiently monitor the population so the model becomes economically sustainable after 2030.
📋 National Best Practices
Technology and consulting companies responding to RFPs across states are already observing best practices in funding, policy recommendations, RFP issuance and responses that benefit both providers and states iteratively.
🌟 Proven Wrap-Around Services
Best-in-class companies already servicing CMS strategic pillars — multilingual patient education, AI-assisted engagement, doula accreditation, virtual care, population dashboards — can be brought in as a pre-vetted coalition.
🧠 Talent & Expertise
Population health program-building talent residing in large health systems, MCOs, and consulting firms should be opened up to states and rural providers through structured partnerships.
🔐 Coalition Building
Battle-scarred leaders who know how to weave together stakeholders, data infrastructure, and governance can de-risk much of this upfront — combining national best practices with local tailoring.