The Rural Health Transformation (RHT) Program is now open for state applications, marking a historic $50 billion investment in rural healthcare.
All 50 states have been invited to submit a one-time application and comprehensive rural health plan by the November 5, 2025, deadline. Funds will be awarded over 2026–2030 to help states modernize rural care delivery, with half of the funding split equally among approved states and the other half distributed based on each state’s plan and rural needs. This is the only application round for the program, and awards will be announced by December 31, 2025.
This program empowers state governments to tackle their unique rural health challenges with unprecedented federal support. Governors will design transformation plans targeting root causes of poor health outcomes in their rural areas. For rural hospitals and clinics, the RHT Program offers a lifeline: funding can support new care delivery models, workforce recruitment, technology upgrades, and other innovations to strengthen sustainable access to quality care in long-underserved communities. With many rural providers facing financial strain, this initiative arrives as a timely boost to help prevent closures and improve health outcomes for rural residents.
Nearly every state is already mobilizing to capitalize on this opportunity, with at least 48 states (as of October 20) launching public stakeholder input processes to shape their applications. Many have formed advisory groups or task forces: Alabama convened an advisory council, Indiana established a multi-agency working group, and North Dakota created an interim legislative committee to identify ways to improve rural health. Florida’s health agency sought ideas on new care delivery strategies, technology solutions, and workforce recruitment, while Minnesota prioritized rural emergency services, chronic care, mental health, substance use treatment, and maternal health. States including Arkansas, Montana, Washington, and Wyoming have submitted or posted letters of intent to apply, signaling strong participation.
Several states have already enlisted expert support to ensure competitive proposals including Mississippi and New Mexico, who hired consultants to help craft comprehensive plans that align with federal criteria. Colorado released a draft framework aligning RHT funds with its broader rural economic initiatives and assigned its Medicaid agency to administer awards to local providers if selected. Wisconsin issued an open request for information, inviting feedback from stakeholders such as EMS units, tribal health organizations, and community nonprofits to ensure local needs drive the state’s priorities. California, Michigan, and Utah passed laws creating dedicated funds or authorizing receipt of RHT grants, while North Carolina and Pennsylvania lawmakers introduced bills to facilitate applications and future allocations.
Maryland has also emerged as an early leader and is actively preparing its application for the RHT Program. Following an RFI on September 9, 2025, the state received over 250 responses, held 17 local listening sessions with more than 250 participants, and on October 20 presented a draft outline of its Rural Health Transformation Plan ahead of the submission deadline.
With the November 5 deadline fast approaching and $50 billion on the line, state leaders and rural stakeholders are urged to finalize and submit robust applications to CMS. Awards will be decided by year’s end, making the coming weeks critical.