The $50 billion Rural Health Transformation Program (RHT) is a landmark federal initiative launched in 2025 to reshape rural healthcare delivery across all 50 states. A five-year federal investment administered by CMS to; expand access to care in rural communities. modernize rural health infrastructure and technology, strengthen the rural health workforce, and support innovative, state-driven care models. The funding structure is $10 billion per year from FY 2026–2030. 50% to be allocated equally across states with approved applications, 50% awarded based on need. Needs include, rural population share, number and condition of rural facilities, and land mass and strategic proposals. States submitted one-time applications in 2025 outlining transformation plans. CMS announced awards in December 2025, with first-year grants ranging from $147M to $281M per state.
The 2026 Chartis Rural Health Snapshot reveals deepening instability, with 41% of rural hospitals operating at a loss and 417 facilities vulnerable to closure. Additionally over 300 hospitals have eliminated OB services and 450+ have cut chemotherapy. Medicaid reimbursements account for nearly 10% (or $3.9 million) in net revenue for the typical rural hospital.
Can this initiative turn these statistics around? Who will take on the challenges to not just spend the $50B but change the rural healthcare landscape?
News
TruBridge Report Highlights Rural Healthcare Leaders’ Optimism Amid Financial Concerns
TruBridge, Inc., a provider of revenue cycle management and technology solutions for rural and community healthcare organizations, released a report assessing how rural hospital executives view federal funding opportunities and shifting reimbursements. The report, “Rural Health at a Crossroads: How RHTP and OBBBA are Reshaping Local Healthcare,” details rural leaders sentiment surrounding the RHTP and the broader financial challenges shaped by the One Big Beautiful Bill Act (OBBBA).
National Grange Releases New Report Highlighting Impact of 340B on Rural Hospitals
The National Grange has released a new report and analysis by Avalere Health examining the impact of the 340B Drug Pricing Program on rural hospitals, underscoring the program’s essential role in preserving access to care for millions of Americans in rural and small-town communities.
Governor Ivey Announces Six Alabama Rural Health Transformation Program Workshops Across State Next Week
Governor Kay Ivey announced that the Alabama Department of Economic and Community Affairs (ADECA) is hosting a series of six workshops across Alabama next week for interested parties to learn more about the new Alabama Rural Health Transformation Program.
Governor Morrisey Announces more than $62 million in Rural Health Transformation Funding Opportunities
Governor Patrick Morrisey announced that more than $62 million in funding opportunities has been made available through West Virginia’s Rural Health Transformation Program (RHTP) at an event at Camden Clark Hospital, a statewide initiative focused on strengthening healthcare access and improving health outcomes across the Mountain State.
Rural hospitals in Missouri warn $50B grant funding won’t offset looming federal cuts
Rural hospitals in Missouri say a $50 billion federal investment in rural healthcare will be insufficient in offsetting upcoming reductions in federal Medicaid reimbursement that will put additional strain on already fragile rural healthcare systems across the state.
RHT Alliance Expands Membership by More Than 50% as States Move From RHTP Planning to Execution
The Rural Health Transformation (RHT) Alliance announced significant national momentum as rural health systems solidify their Year 1 plans and turn their attention to Year 2 implementation and planning. As state-level RHT strategies rapidly take shape, the Alliance is issuing an open call to healthcare providers seeking partners who can help deliver on their strategy and accelerate time-to-value on RHT funding.
$93.5 Million Available for Arkansas Rural Healthcare Improvements
Arkansas officials have opened the application process for the second round of funding through the state’s Rural Health Transformation Program, making more than $93.5 million available to support healthcare improvements in rural communities.
Bassett Healthcare Network opens new clinic and expands rural healthcare options
For residents and travelers alike, Bassett Healthcare Network’s new Convenient Care Center in Milford builds on their goal of providing more healthcare options to people in rural settings.
North Dakota launches initiative focused on suicide prevention support and training for rural healthcare providers
North Dakota is launching a new rural healthcare suicide prevention initiative aimed at strengthening follow-up care and closing critical gaps after suicide risk is identified. The effort follows recommendations from the North Dakota Suicide Fatality Review Commission and supports the Zero Suicide framework across rural and tribal healthcare systems.
Idaho posts first three federal rural healthcare subgrants connected to ‘Big Beautiful’ funding
Idaho Department of Health and Welfare officials are soliciting organizations to improve maternal, perinatal and child health access in rural areas in its first round of subgrants using a $186 million federal grant.
TruBridge Signs CMS Health Tech Ecosystem Pledge as Nation’s Leading Rural Healthcare Platform
TruBridge, Inc., a provider of revenue cycle management and technology solutions for rural and community healthcare organizations, announces the signing of the Centers for Medicare & Medicaid Services (CMS) Health Tech Ecosystem Pledge on prior authorization. TruBridge signs this pledge as a dedicated voice for rural health providers across the nation.
Listening Spotlight
Host Phil Sobol, Chief Commercial Officer at CereCore, and Holly Davis, Chief Nursing Officer of Bingham Memorial Hospital, a rural CNO, discuss healthcare innovation that actually helps nurses.
In this session, Scott Cook, VP of Business Development at Infinx, unpacks what the Rural Health Transformation Program may mean in practice. The conversation will explore what the funding is designed to accomplish, why each state’s approach matters, and how rural healthcare organizations should think about sustainability once the five-year funding period ends. The session will also look at the operational burden behind transformation funding. Rural health teams may be asked to apply for, justify, track, and operationalize funding while already managing workforce shortages, payer pressure, technology gaps, and limited administrative capacity.
On this episode hosts Angie Shin and Dave Smith engage with healthcare operations and analytics professional, Zac Rice from Bingham Memorial in Blackfoot, Idaho. Zac walks through the full arc: how you find internal referral leaks, fix them with people and process, then partner with the right technology to turn a one-time win into a compounding system that funds MRIs, robots, and better care for a rural community.
Events
2026 National Organization of State Offices of Rural Health Annual Meeting (NOSORH)
When: September 1-3, 2026
Where: Pittsburgh PA
Event Page
Register for this event.
Resources
The Rural Health Transformation (RHT) Program was authorized by the One Big Beautiful Bill Act (Section 71401 of Public Law 119-21) and empowers states to strengthen rural communities across America by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem. Through innovative system-wide change, the RHT Program invests in the rural healthcare delivery ecosystem for future generations.
The National Rural Health Association (NRHA) is a national nonprofit membership organization that brings together thousands of members across the United States.
The association’s mission is to provide leadership on rural health issues through advocacy, communications, education and research.
NRHA Events
NRHA Press Releases
NRHA’s Rural Health Voices Blog
