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
CMS Announces Investment Dollars Through the RHT
The Centers for Medicare & Medicaid Services (CMS) is accelerating a once‑in‑a‑generation modernization of rural health care through a series of targeted federal investments now reaching communities across the country. From major technology upgrades and workforce expansion to improved care coordination, transportation access, and digital interoperability, these awards reflect a unified national strategy: strengthen rural health systems, close long‑standing access gaps, and ensure every American, regardless of ZIP Code, can rely on high‑quality, modern care.
New AHA Report Warns Access To Care Is At Risk In Rural Communities
The American Hospital Association (AHA) recently released a new report warning that access to care is increasingly at risk in rural communities across America as a convergence of workforce shortages, financial pressures and policy changes threatens hospitals’ ability to maintain essential services.
Access to rural healthcare is bigger than hospitals – and North Carolina is leading the way
By Julianne Malveaux – A lot of people hear the phrase “rural health” and automatically think about hospitals. They think about how North Carolina facilities are struggling to keep their doors open or about maternity wards shutting down. Widespread shortages of physicians and nurses, or the long drives to see a specialist, probably come to mind too. Those are all valid concerns. Rural hospitals are essential to their communities and are struggling. North Carolina is right to invest in them through the Rural Health Transformation Program. But hospitals are only part of the rural healthcare access story. Read more.
Bipartisan bill aims to close rural NC’s health care workforce gaps
By Jaymie Baxley – Two North Carolina congressional representatives, a Republican and a Democrat, have teamed up on federal legislation meant to recruit and retain doctors, nurses and other health care workers in rural communities. U.S. Reps. Pat Harrigan (R-10) and Don Davis (D-1) say the bill, which they’ve dubbed the REACH Act, is designed to address persistent provider shortages that leave many rural Americans struggling to find care. Short for Resources for Essential Access to Community Health, it would give a refundable tax credit of up to $10,000 to eligible workers in rural areas. Read more.
Event: AI’s role in rural healthcare transformation
By Jessica Hagen – Deploying technology is necessary to expand access to care in rural communities, but connecting patients with follow-up care, supporting local providers and deploying services that remain sustainable after government funding ends are equally vital, according to a panel at the Verizon Healthcare on Air Summit in Los Angeles recently. Read more.
New southern Minnesota clinic aims to close rural health care gaps
As rural health care shrinks across the state, one health system is hoping to help reverse the trend. Fairmont Clinics has opened its doors in southern Minnesota. To start, it will offer general surgery, OB-GYN and urology care. Down the line, patients will also be able to receive primary and urgent care as well as higher level surgeries.
Hospital closures on the rise in both rural and urban areas—particularly among safety-net hospitals
By Karen Feldscher – More hospitals across the U.S. are closing than opening, and urban hospitals are closing at the same rate as rural ones, according to a new study led by Harvard T.H. Chan School of Public Health. Further, the hospitals that close are more likely to be those serving socially vulnerable communities. Read more.
The ROI of Virtual Assistants in Healthcare Recruitment: Addressing Rural Provider Shortages
Rural clinics across the country are trying to solve an old problem with an old tool: hire more staff, build more space, and hope the budget holds. But the shortage of doctors, nurses, and administrative workers in rural America is not a staffing dip. It is a structural gap that new buildings cannot fix on their own. A healthcare virtual assistant offers a different path. Instead of adding bricks and payroll, rural providers can add capacity through remote support that plugs directly into existing workflows.
States Bet Big on Rural Health Startups, With a Silicon Valley Twist
By Sarah Jane Tribble – When Josh Fleig, Louisiana’s chief innovation officer, learned his state had set aside $20 million a year, for five years, to invest in startup rural health companies, his reaction was not surprising: “Wow!” In rural America, where people are often reported to be sicker with poor access to healthcare, the cash influx is a relief. In the economic development space where Fleig operates, it’s an opportunity. Read more.
HHS Awards Nearly $25 Million to Strengthen Small Rural Hospitals and Preserve Access to Care
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced awards to 132 hospitals totaling nearly $25 million through the Rural Hospital Provider Assistance Program to help eligible small rural hospitals maintain their medical workforce, sustain essential healthcare services, and strengthen access to care for the communities they serve across 13 states.
Marshall University Idea District welcomes Synthesis Health to advance rural health and radiology innovation
Marshall University’s Idea District is expanding its growing healthcare innovation ecosystem with the addition of Synthesis Health, a Canadian-based, radiology-focused company locating an operation in Huntington. The new venture is positioned to improve diagnostic care in rural and underserved communities while developing technologies with applications across the United States and global healthcare markets.
The Georgia Cyber Center at Augusta University’s Cyber Resiliency Center Advances Rural Health Transformation Through Secure, Innovative Care Delivery
The Cyber Resiliency Center (CRC), part of the Georgia Cyber Center at Augusta University, announced a strategic alignment of its rural healthcare cybersecurity and resilience initiatives with the Georgia Department of Community Health and Rural Health Transformation (RHT) Program objectives established by the Centers for Medicare & Medicaid Services (CMS). This alignment strengthens Georgia’s ability, and establishes a scalable model for other states, to modernize rural healthcare delivery while safeguarding patient data, sustaining access to care, and accelerating innovation.
Listening Spotlight
More to Read on Rural Healthcare
Events
Rural Health Day Summit: Cultivating mental well-being in rural communities
When: November 19, 2026 12:00 – 3:00 pm ET
Where: Virtual Webinar
Event Page
Register for this event.
Mental Health America (MHA) is hosting a summit in observance of National Rural Health Day, focused on supporting the unique mental health challenges of rural communities and workforces. The event will spotlight actionable strategies from experts, community leaders, and MHA resources to promote well-being and resilience across rural workplaces, families, and communities.
AscendRural Summit 2026
When: November 30 – December 2, 2026
Where: Eagan MN
Event Page
Join leaders from across sectors to explore what’s working, and what’s next, in advancing rural well-being through technology. The Summit is designed as a journey – from understanding today’s rural transformation moment, to discovering innovative models and partnerships, to turning ideas into meaningful action.
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
