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
Ball State University Receives Grant to Strengthen Rural Health Workforce, Access to Care
Ball State University has received funding through the Indiana Rural Health Transformation Program to strengthen the rural healthcare workforce and expand access to health services in East Central Indiana. The $358,170 award, covering Sept. 1, 2026-July 31, 2027, will support work led by Ball State’s College of Health as part of the state’s Growing Rural Opportunities for Well-being (GROW) Regional Grants initiative.
Governor Reeves Announces 167 Rural Health Transformation Program Awards Totaling More Than $104 Million
Governor Tate Reeves recently announced 167 awards totaling $104,115,146 through the Mississippi Rural Health Transformation Program. The awards are part of Mississippi’s $205.9 million first-year implementation budget, which will be allocated this year. They will help modernize, strengthen and transform healthcare in rural communities across the state.
Marshall Health Network awarded Rural Health Transformation Program Grant for workforce health initiative
Marshall Health Network’s (MHN) proposed Worksite Clinic Expansion Initiative was among the first grants awarded recently through the State of West Virginia’s Rural Health Transformation Program.
$50B Rural Health Transformation Program needs more transparency, groups say
By Arielle Zionts – One year into its creation, a $50 billion federal program aimed at improving rural health care lacks transparency, which could make it difficult to protect against fraud, identify successful projects, and ensure the program delivers on its promise to transform the system. Read more.
Sanders Announces Nearly $150 Million Awarded in Rural Health Transformation Funds
Governor Sarah Huckabee Sanders recently announced $149.3 million in awards to recipients of the first round of Rural Health Transformation Program (RHTP) grants, established through President Trump’s One Big Beautiful Bill.
Governor Ivey Announces First Grants in Major New Rural Healthcare Program Totaling More than $144 Million
Governor Kay Ivey recently announced the awarding of 138 grants worth a total of more than $144 million to healthcare providers and institutions throughout the state as part of the Alabama Rural Health Transformation Program (ARHTP). The funds awarded today will support projects covering rural areas in each Alabama county to improve healthcare access, quality and outcomes.
Governor Ivey Announces First Grants in $144 Million Rural Healthcare Program
Gov. Kay Ivey recently announced the awarding of 138 grants totaling more than $144 million to healthcare providers and institutions across Alabama as part of the Alabama Rural Health Transformation Program. The grants will fund projects designed to improve healthcare access, quality and outcomes in rural communities across all 67 Alabama counties.
Governor Gordon and Senator Barrasso Announce the Final Approval of Wyoming’s Rural Health Transformation Program by Feds
The Centers for Medicare and Medicaid Services has granted final approval of Wyoming’s Year one-year application for $205 million in federal funding through the Rural Health Transformation Program (RHTP), a five-year initiative authorized through the Working Families Tax Cuts law. Wyoming was initially notified of the award in December 2025 and has since worked with CMS to ensure the state’s plan reflects Wyoming’s healthcare priorities and the needs of its rural and frontier communities.
More to Read on Rural Healthcare
Listening Spotlight
The Rural Health Transformation Program in Plain English
Carrie Foote breaks down the Rural Health Transformation Program in plain English and shares how rural health clinics should be thinking about partnerships with hospitals, tech vendors, and state agencies.
All that, plus the Flava of the Week about Cityblock’s rumored acquisition of Homeward. How are the two primary care startups reportedly considering joining forces, and how can building within existing payment models lead to expanding access to those who need it the most?
Events
AscendRural Summit 2026
When: November 30 – December 2, 2026
Where: Eagan MN
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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.
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