Federal
HHS Region 0 · Centers for Medicare & Medicaid Services (CMS)
Program Overview
The Rural Health Transformation (RHT) Program, managed by CMS, aims to strengthen rural healthcare across America by improving access, quality, and outcomes through innovative system-wide change and sustainable investments. The program focuses on strategic goals such as disease prevention, expanding workforce capacity, advancing technology, and fostering innovative care models. Funding of $50 billion will be allocated to states over five years, supporting a range of activities to transform rural health delivery systems.
Updated about 2 hours ago
87
RHTP Documents
$411.0B
Award Amount
$562.4B
Total Budget
0
CAH Count
Demographics
- Uninsured rate
- 11.3%
- CAH count
- 39
Current Progress
Oklahoma is in the planning-to-launch phase, hiring program and initiative management staff and allocating multi-year budgets as part of its approved RHTP initial award from CMS. Major positions are to be filled starting in 2026 with foundational efforts to stand up projects and collaborative networks underway.
Nevada has submitted its initial and revised RHTP applications and completed stakeholder engagement, with legislative approval pending to process federal funds. The state is forming a steering committee and preparing for launch upon fund receipt.
Nevada has launched BP1 of its RHTP Flex Fund initiative, opening the application process for rural health system modernization projects. RFA and program materials are available and the state is soliciting proposals from eligible providers and partners.
RHTP Strategy
Oklahoma's RHTP strategy invests in regional governance, technology, primary care transformation, hospital partnerships, and population health initiatives. The state is funding a Rural Health Collaborative, expanding rural healthcare access through infrastructure, workforce, maternal health value-based payments, EHR/HIE connectivity, and rural Medicaid transformation via the Oklahoma Health Care Authority. Emphasis is placed on sustainability, interagency coordination, and leveraging technology and data to support value-based and high-quality rural care.
Model
Value-based payment, clinically integrated networks, statewide HIT/EHR/HIE expansion, workforce incentives, and Medicaid transformation.
Key Initiatives
- Rural Health Collaborative Nonprofit and Rural Clinically Integrated Network
- Maternal Health Value-Based Payment Pilot
- Community Health Worker expansion at FQHCs/hospitals
- EHR and HIE expansion for rural facilities
- School-based health services NOFO
Timeline: 2026-2030
Community Health Metrics
Source: CDC PLACES 2024 ↗County-level estimates averaged across Federal — % of adults 18+ unless noted
RHTP Strategic Goals
- 1Expand access to coordinated, high-value care for rural Oklahomans.
- 2Strengthen rural provider networks and care transformation capabilities.
- 3Invest in technology and workforce to support sustainable rural health delivery.
- 4Improve population health outcomes and social determinants of health.
- 5Make rural Nevada healthier
- 6Strengthen rural health systems
- 7Increase number of rural network providers
- 8Fill gaps with innovative technology solutions
- 9Promote value-based and innovative care models to prevent and manage chronic disease.
- 10Bolster and modernize rural health care infrastructure (technology, equipment, supplies, emergency services).
Award Announcements (16)
Flex Fund Request for Applications Announcement-REVISED
This document is Nevada's official Request for Applications for the Rural Health Transformation Program (RHTP) Rural Health System Flex Fund, funded by the CMS and authorized under the One Big Beautiful Bill Act. It announces $35,986,322 in federal funds for BP1 to modernize rural health care infrastructure through technology, emergency services, telehealth, and workforce initiatives. The document outlines eligibility, targeted activities, deadlines, and application instructions for rural health stakeholders seeking RHTP subawards.
Shoring Up to Sustainability Grant Application
This document is the Request for Applications for South Carolina's Shoring Up to Sustainability Initiative under the federal Rural Health Transformation Program (RHTP), funded by CMS. It details project options (Facility Enhancements, Masterclass Training Series, Healthcare Workforce), eligibility, timelines, total award amounts, federal share, and requirements for subrecipients. The initiative is a major component of South Carolina's state RHTP transformation plan to bolster rural health system sustainability and workforce.
RHTP for RHTSC 3.11.26.pdf
The document details Nevada's FY2026 award of $179,931,608.42 under the Rural Health Transformation Program, launched by the One Big Beautiful Bill Act and administered by CMS. It outlines strategic investment areas and programmatic priorities for RHTP federally funded initiatives in rural health infrastructure, workforce, technology, and population health outcomes across rural Nevada for BP1 (2025-2026). Milestones, funding allocations, and performance targets for telehealth and workforce are provided.
DRAFT RHT RFA Flex Funds - 2026.pdf
The Nevada Rural Health Transformation Program's Rural Health System Flex Fund offers $35,986,322 in federal support for BP1 (2025-2026) through a competitive subaward process. Projects focus on modernizing rural health infrastructure, supporting EMS development, health IT, workforce recruitment, and collaborative purchasing for sustainability. Funds are from CMS under RHTP, authorized by the One Big Beautiful Bill Act, with no match required and strict outcome measures.
Nevada Workforce Recruitment and Rural Access Program Provider Recruitment and Retention Program Request for Applications Announcement
This document is a Request for Applications for Nevada's Rural Health Transformation Program (RHTP), Workforce Recruitment & Rural Access Program (WRRAP), funded by CMS under the One Big Beautiful Bill Act. The RHTP aims to transform rural healthcare by recruiting and retaining providers, supporting infrastructure modernization, and expanding access to specialty services. $32,387,689 is available for BP1 to support a variety of tiered workforce and rural health access initiatives in Nevada's rural and frontier counties.
CMS Notice of Funding Opportunity (NOFO) for RHT Program
This document is the federal Notice of Funding Opportunity for the Rural Health Transformation Program, a $50 billion initiative for state transformation of rural health care delivery systems. It describes program funding, eligibility, application procedures and deadlines, permissible uses of funds, and strategic objectives. States are invited to apply for funding to advance rural health innovation, workforce development, technology adoption, and delivery system transformation beginning in FY2026.
Wellness Within Reach Grant Application
This is a FY2026 Request for Applications for the Rural Health Transformation Program: Wellness Within Reach Initiative, administered by SCDHHS as part of South Carolina's RHTP transformation plan under a $200M+ federal CMS/HHS award. The announcement solicits applications from rural health providers and partners to implement two priority projects: Mobile Crisis Response and Expanding Community Care Sites. The initiative aims to bring high-quality, face-to-face healthcare to rural communities via mobile units and new care sites, with awards totaling $27.7 million for the first grant cycle.
Leveling Up Grant Application
This document is a Request for Applications (RFA) by the South Carolina Department of Health and Human Services (SCDHHS) for the Rural Health Transformation Program (RHTP) Leveling Up Initiative, funded by CMS. It solicits applications to expand chronic disease management programs in rural areas statewide, as part of the state's RHTP plan. $27 million in RHTP federal funding is available for FY2026, with awards anticipated by July 31, 2026 and required expenditure by September 30, 2027.
Arizona’s Notice of Award 12/29/25
This is the official Notice of Award for Arizona's Rural Health Transformation Program (RHTP), funded under the Big Beautiful Bill Act of 2025, Section 71401. Arizona was awarded $166,988,955.92 to transform rural healthcare delivery—including telehealth, integrated care, behavioral health, chronic disease, child and maternal health, and workforce. The award defines financial terms, reporting requirements, milestones, and restrictions tied directly to RHTP implementation in Arizona.
Notice of Award
This document is the official Notice of Award for the Utah Rural Health Transformation Program, issued under the federal Rural Health Transformation Program (RHTP) by CMS pursuant to the Big Beautiful Bill Act of 2025, Section 71401. Utah is awarded $195,743,566.29 for generational investments in building resilient, sustainable rural health systems. Initial funds are restricted pending a revised budget, with clear requirements for ongoing reporting and performance reviews.
CMS NOFO for Reference
This notice of funding opportunity describes the $50 billion Rural Health Transformation Program (RHTP), authorized by the One Big Beautiful Bill Act, for states to submit applications to transform rural healthcare delivery. The program aims to improve access, quality, outcomes, workforce, technology, and payment innovation for rural communities across the United States. Key strategic goals, eligibility, permissible uses of funds, and the application/award timeline are provided for states participating in this federal initiative.
NOA_RHTCMS332082-01-00-redacted.pdf
This document is the Notice of Award for Wyoming's Rural Health Transformation Program (RHTP) application under the One Big Beautiful Bill Act. It details the award amount, required terms and conditions, restrictions on initial drawdown of funds pending budget revision, and reporting deadlines for progress and financial reports. The award is administered by CMS and outlines the program's period of performance and cooperative agreement structure.
Notice of Award Dec. 29, 2025
This document is a CMS award notice for Texas under the Rural Health Transformation Program (RHTP), authorized by the Big Beautiful Bill Act of 2025, Section 71401. It includes fiscal award details, recipient and federal agency contacts, terms and conditions for cooperative agreement compliance, and outlines mandatory reporting deadlines, progress report requirements, and allowable cost categories. The award totals $281,319,360.67 for the first budget period, with future periods and continuation funding contingent on satisfactory performance and compliance.
Notice of Funding Opportunity
This Notice of Funding Opportunity (NOFO) describes the application and award process for the $50 billion Rural Health Transformation Program (RHTP) under Public Law 119-21. Administered by CMS, the program aims to support state governments in transforming rural healthcare through innovation, workforce development, technology, partnerships, and targeted investments. All 50 states are eligible to apply for cooperative agreement funding to implement strategic, outcomes-driven initiatives benefiting rural populations.
Nevada's RHT Program Notice of Award (NOA)
This document is a Notice of Award to the Nevada Health Authority for the Rural Health Transformation Program, authorized by the Big Beautiful Bill Act of 2025. The award totals $179,931,608.42 and covers the budget period from December 29, 2025 through October 30, 2030. The document details award terms, reporting requirements, budget milestones, and funding limitations for Nevada's cooperative agreement under RHTP.
Attachment B - CMS Notice of Award
This document is a federal award announcement for the Kentucky Rural Health Transformation Plan, funded under the Rural Health Transformation Program (RHTP) of the One Big Beautiful Bill Act of 2025. The award, totaling $212,905,590.56, is managed as a cooperative agreement with CMS, with required milestones, reporting, and revised budget submission for the first budget period. The period of performance spans December 29, 2025, to October 30, 2030, and includes fiscal and progress report requirements tied to CMS oversight.
Reports (3)
Approved Budget Period 1 Revised Budget Narrative
Texas Health and Human Services Commission submits a revised RHTP Budget Period 1 proposal, funded via CMS Notice of Award RHTCMS332068-01-00, with $281.3M allocated across six initiatives. Key activities include direct and competitive awards to rural hospital districts and hospitals (Initiative 1), accelerated workforce development (Initiative 4), and infrastructure investments (Initiative 6). Revised funding aligns with CMS guidance and emphasizes stakeholder engagement, accountability, and timely implementation for rural health transformation.
Slides
The Indiana Rural Health Transformation Program (RHTP), supported by a $207 million federal award, is implementing 12 strategic initiatives to improve rural health access, quality, and outcomes. Initiatives span emergency care coordination, health information exchange, workforce pipelines, telehealth expansion, and population health improvement. The GROW Regional Grants program is launching to catalyze regional, community-driven transformation aligned with state and federal rural health objectives.
Budget Period 1 Revised Budget Narrative
This document details the revised Year 1 budget and five-year allocation for Texas's Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. HHSC will distribute $281M annually, focusing on six initiatives including rural hospital district awards, workforce development, EMS enhancements, behavioral health, and population health monitoring, with a total budget exceeding $1.4 billion. The report outlines procurement, personnel, and travel plans, partners, and compliance with CMS RHTP requirements.
Strategy & Summaries (23)
Download
This document details the Arkansas Rural Health Transformation Program's state transformation plan as part of the Rural Health Transformation (RHT) Program. Arkansas targets all rural counties with an array of initiatives to expand access, foster network development, modernize technology, grow the rural workforce, and transition hospitals toward sustainable value-based care. With $150 million in funding, the plan sets clear annual performance targets across innovative preventive programs, workforce initiatives, telehealth and EMS infrastructure upgrades, and rural facility stabilization.
RHT Public Workshop Presentation Slides-10/02/2025
This document is a Nevada Health Authority (NVHA) public workshop presentation on the Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act, outlining Nevada's application strategy, stakeholder engagement, and proposed transformation priorities. It details strategic goals, partnership engagement, use-of-funds requirements, and the state's timeline for RHTP application and implementation. Key focus areas include workforce development, prevention, sustainable access, innovative care models, and technology innovation for rural health.
CMS-approved Maryland RHTP
This document is Maryland's comprehensive strategic plan for the Rural Health Transformation Program (RHTP), covering all rural counties in the state. It outlines three major initiatives: transforming the rural workforce, promoting sustainable and innovative care, and increasing access to nutritious food, with substantial investments targeting workforce, HIT, population health, and financial stabilization. The plan details governance, funding methods, programmatic strategies, and expected outcomes in line with federal RHTP priorities.
Transcript
This federal webinar provides an in-depth overview of the $50 billion Rural Health Transformation Program (RHTP), created under Public Law 119-21 to support comprehensive rural health system transformation in all 50 states via a competitive, one-time application process. It outlines application requirements, strategic goals, allowable activities, budget guidance, milestones, and timelines for state applicants, as well as funding formulas and performance plans. The session also details program administration, reporting, stakeholder engagement, and sustainability expectations under the RHTP.
Rural Health Transformation (RHT) Program | CMS
The Rural Health Transformation Program (RHTP), a $50 billion initiative authorized by the One Big Beautiful Bill Act, aims to transform rural healthcare nationwide by supporting state-based innovation, sustainability, workforce development, care coordination, and technology advancement. The program will fund approved states from FY2026 to FY2030, with application and award timelines set for late 2025. Strategic goals include improving rural health access, fostering tech solutions, and enabling innovative care and workforce models.
RHT Program Public Workshop Presentation Slides 2/18/2026
This document summarizes Nevada's FY2026 Rural Health Transformation Program (RHT) initiatives under the federal One Big Beautiful Bill Act. Nevada was awarded $179,931,608 in CMS RHT funding for 2026 to support workforce development, rural infrastructure, innovation, telehealth, and population health outcomes, leveraging multiple strategic initiatives and subrecipient programs. The summary outlines application processes, timelines, strategic goals, and priority investment areas, with all funding 100% federally supported pending final budget approval.
RHT Program Public Workshop Presentation Slides-03.05.2026
This document provides a broad overview of Nevada’s Rural Health Transformation Program (RHT), established under the One Big Beautiful Bill Act. It details $179,931,608 in Year 1 funding awarded to Nevada to implement major initiatives around workforce, infrastructure, rural health outcomes, and technology. Key milestones, performance targets, and annual application and spending requirements are outlined.
Rural Health Transformation Program
This summary outlines the Rural Health Transformation Program (RHTP) established by the OBBBA, appropriating $50 billion in federal funding to all 50 states from FY2026 to FY2030. It describes the distribution mechanism, allowable activities, and strategic goals of RHTP, designed to stabilize and strengthen rural hospitals, support workforce, and promote technology-driven solutions for rural communities.
Community Meeting Overview
This document is a summary and overview of Louisiana's strategy and approach for the federally established $50 billion Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. It outlines the requirements, allowable uses, and planned timeline for Louisiana's application, including the state's definition of rural areas, strategic goals, and community engagement in transformation planning. Key focus areas include chronic disease prevention, technology adoption, workforce development, and improving rural health outcomes.
Presentation to Interim Rural Health Transformation Committee
This document provides a comprehensive overview of the North Dakota Health and Human Services Rural Health Transformation Program (RHTP) as authorized under the One Big Beautiful Bill Act. It details federal funding and scoring, strategic priorities, survey results, tribal consultation, allowable and unallowable uses of funds, and anticipated program implementation milestones, outlining North Dakota's eligibility and approach to receive at least $500 million from federal baseline funding between FY2026 and FY2030.
RHTP Overview Slides
This overview describes Connecticut's implementation of the Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act, supported by a $154 million CMS grant for FY2026. The program involves 31 projects across four transformation initiatives: population health, workforce, technology, and care transformation/stability, all designed to enhance quality, access, and sustainability of rural healthcare. Projects are under CMS review, with funding expected in March 2026, and include major collaborative efforts across multiple state agencies.
Rural Health Transformation (RHT) Program Overview
This document provides an overview of the Rural Health Transformation Program (RHTP), a $50 billion initiative created by the One Big Beautiful Bill Act to transform care and improve outcomes in rural communities. It summarizes eligible use of funds, program strategic goals, and application requirements, and provides a timeline for application and awardee selection. Key goals include prevention and chronic disease management, workforce development, behavioral health, and technology advancement.
AHCCCS Initiatives and Best Practices
Arizona's RHTP is a $167 million investment strengthening rural healthcare, expanding access, building the workforce, and backing rural health systems for over 786,000 rural residents. The program, led by AHCCCS from December 2025 through October 2030, funds rural hospitals, clinics, Tribal health entities, universities, nonprofits, and community organizations with a focus on workforce development, priority health initiatives, expanded access, and system support.
https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2025/rural-health-transformation-program-summary.pdf(link is external)
This document summarizes the $50 billion federal Rural Health Transformation Program (RHTP) established by the One Big Beautiful Bill Act in July 2025. It outlines RHTP program structure, state application requirements for transformation plans, allowable uses of funds—including quality improvement, technology adoption, workforce recruitment, and financial stabilization—and program milestones. The summary details the definition of eligible rural health facilities and requirements for annual reporting and compliance.
Arizona’s RHT Program White Paper
The document details Arizona's successful application and initial award for the CMS-administered Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. Arizona will use a $167 million award to expand access, improve workforce, and pilot value-based models in rural and Tribal areas via strategic investments in telehealth, workforce development, and health equity. The state will launch the program with a phased, five-year statewide implementation and robust stakeholder engagement.
RHTP Initiatives Summary Packet.
This document summarizes the Oklahoma Rural Health Transformation Program (RHTP), a federally funded state transformation initiative created under the One Big Beautiful Bill Act. It outlines major activities for the first budget period, including maternal health RPM, school-based health service expansion, rural transportation, telestroke networks, paramedic and doula training, behavioral health integration, tech cooperative development, community referral platforms, chronic disease management, workforce initiatives, and collaborative network infrastructure. The plan details sustainability pathways and governance for each initiative and includes timelines for implementation from December 2025 through October 2030.
Public Webinar Slides - Sept 2025 (PDF)
This document is a public webinar overview of Maine's development and application process for the Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. It outlines key federal goals, funding timelines, application and public engagement steps, and allowable activities and priorities for Maine's proposal. The webinar details relevant partners, application requirements, and upcoming key dates for stakeholder involvement.
Rural Texas Strong – Frequently Asked Questions
This FAQ document describes the Rural Texas Strong (RTS) program, Texas' implementation of the federal Rural Health Transformation Program (RHT) under the One Big Beautiful Bill Act. Texas was awarded $281.3 million by CMS for the first year of this 5-year RHT initiative, with processes for updating budgets and awarding funds described. RTS funding supports six initiatives focused on transforming rural health in Texas between 2026 and 2030.
Understanding the CMS Health IT Ecosystem
This NVHA-hosted workshop introduces rural, frontier, and Tribal healthcare providers in Nevada to the CMS Health IT Ecosystem, specifically in support of Nevada’s Rural Health Transformation Program (RHTP). The event is linked to Nevada’s forthcoming Rural Health Innovation & Technology (RHIT) funding initiative under RHTP, with full financial support from CMS/HHS. The session aims to build understanding of health IT integration and support technology-enabled rural care.
Understanding the Impact of H.R.1 and Federal Changes to Medicaid | Department of Health Care Policy and Financing
H.R.1 establishes the $50 billion Rural Health Transformation Program (RHTP) for which states, including Colorado, may apply. Colorado Department of Health Care Policy and Financing (HCPF) received initial funding and has begun early-stage implementation of RHTP. The program provides federal grants to transform rural health care delivery for hospitals, health centers, and behavioral health providers.
Rural Health Transformation 50 State Spotlights
This is a high-level summary, prepared by the CMS Office of Rural Health Transformation, of multiple state applications for FY2026 funding under the Rural Health Transformation Program. Each state outlines strategic priorities such as digital and telehealth innovations, workforce expansion, care coordination, maternal and chronic disease health improvement, and rural hospital and EMS support, anticipating measurable improvements in rural healthcare access, outcomes, and delivery.
Invitation to Comment: Rural Health Transformation Program | mydss.mo.gov
The Missouri Department of Social Services solicits public input for the Rural Health Transformation Program application, a new federal initiative created under the One Big Beautiful Bill Act. Missouri's application will be shaped by feedback collected in this public comment period, with funding categories to be selected based on state priorities for rural healthcare transformation.
Provider Payments Fact Sheet
This fact sheet provides guidance on allowable and unallowable uses of Category B Provider Payments under the Rural Health Transformation Program. It outlines restrictions, sustainability requirements, and the 15% cap on Category B funding, as well as allowable example expenditures tied to state RHT transformation plan initiatives. The document clarifies payment models and directs states to ensure RHTP funds do not duplicate existing programs.
Other Documents (45)
Budget Narrative
This document is a detailed RHTP budget narrative and application for Oklahoma covering FY2026–FY2030, specifying an initial award of $223,476,948.62 and a total planned federal budget of over $1 billion. It outlines funding allocations, personnel plans, and multi-year initiatives ranging from workforce and education to technology upgrades and maternal health value-based payment pilots, all under Oklahoma's federally supported Rural Health Transformation Program. Multiple key milestones, partners, and statewide transformation projects tied explicitly to the CMS Rural Health Transformation Program are delineated.
Revised Project Narrative - 01.30.2026
Nevada's RHTP application details a comprehensive transformation plan to improve access, workforce, financial stability, and technology for rural health systems and residents. The Nevada Health Authority proposes targeted strategic goals and initiatives backed by $180 million in federal funds, aiming to make rural Nevada healthier, stabilize rural hospitals, recruit providers, and implement innovative tech solutions. Specific performance targets and milestones are outlined with state and federal oversight, and broad stakeholder engagement via a Rural Health Transformation Steering Committee.
here
The document is Hawaii's application for a federal Rural Health Transformation Program (RHTP) cooperative agreement, requesting $1 billion over five years from CMS. It proposes six interconnected strategies addressing rural health access, technology, EMS, workforce shortages, behavioral health, and provider financial stability, targeting nearly 594,000 rural residents statewide. The plan prioritizes digital infrastructure, telehealth, EMS system modernization, workforce pipeline development, medical respite care, and supports for value-based care adoption aligned with the CMS AHEAD model.
RHTP Budget Narrative*
This document is California's Budget Narrative for the Rural Health Transformation Program (RHTP), detailing the state's proposed CA-RHT initiatives for the 2026-2027 period under federal RHTP. It outlines three major initiatives—Transformative Care Model, Workforce Development, and Technology & Tools—supported by $233.6 million in federal grant funds, along with comprehensive staffing, implementation structure, personnel costs, travel, and subrecipient grant strategies. The plan establishes HCAI as program lead, sets up leadership and evaluation processes, and targets the expansion of care networks, workforce, and IT capacity across rural California.
Connections to Care Grant Application
This document is the RFA for South Carolina's FY2026 Rural Health Transformation Program: Connections to Care Initiative, funded by CMS under the RHTP. It invites eligible rural healthcare providers and organizations to apply for subawards supporting projects to modernize health IT and expand remote patient monitoring and assistive technologies. The total anticipated award for this RFA is $75,000,000, fully federally funded, with activities and reporting aligned to CMS requirements and state strategic goals for rural health transformation.
Rural Veterans Health Transformation Request for Applications Announcement
This document is a Request for Application for the Nevada Rural Health Transformation Program (RHTP) Rural Veteran Health Transformation funds under the One Big Beautiful Bill Act. $2,384,094 in federal funds is available for Budget Period 1, supporting projects improving rural Veteran health in Nevada through infrastructure, workforce, innovation, and technology investments. The funding opportunity is for projects with significant impacts and direct benefits to rural health care and Veteran populations.
Rural Correctional Health Transformation Request for Applications Announcement
This document is a Request for Application for Nevada's Rural Health Transformation Program (RHTP) focused on rural corrections health, funded under the One Big Beautiful Bill Act via CMS. $2,384,094 is available in Budget Period 1 to modernize rural correctional healthcare infrastructure, support innovative care models, technology upgrades, workforce recruitment, and data-driven quality improvement exclusively for rural corrections facilities. Applications are due April 30, 2026, and must align with four strategic initiatives identified by NVHA, ensuring measurable outcomes for rural justice-involved populations.
Nevada Workforce Recruitment and Rural Access Program Provider Apprenticeship and Training Program Request for Applications Announcement
This document is a Request for Applications for the Nevada Workforce Recruitment & Rural Access Program (WRRAP), implemented under the federal Rural Health Transformation Program as authorized by the One Big Beautiful Bill Act. It details BP1 funding ($14,394,529) for new workforce apprenticeship and training grants to expand rural provider recruitment, training, and retention. Multiple strategic initiatives, explicit reporting requirements, eligibility criteria, and a tiered funding model are outlined to enable systemic rural health workforce transformation across Nevada.
Rural-Health-Transformation-in-Wyoming-final-application.pdf
This is Wyoming's RHTP application to CMS under the One Big Beautiful Bill Act outlining state transformation initiatives. The proposal targets $200 million for improving rural care access, EMS and workforce, provider viability, technology adoption, and health outcomes. It details Wyoming's rural demographics, needs, strategic goals, stakeholder engagement, and a multi-initiative implementation roadmap.
Rural Health Transformation Program Application
This is Louisiana's application to the federal Rural Health Transformation Program (RHTP), detailing a strategic framework for rural health system transformation. The plan covers expansion of the rural workforce, modernization of technology (including a statewide shared EHR), value-based payment models, and targeted health initiatives. Partnerships and performance metrics are outlined to improve care access, quality, and outcomes for 1.1 million rural residents statewide.
Project Abstract Summary
South Carolina Department of Health and Human Services submitted an RHTP application to transform rural health care through five integrated, outcomes-driven initiatives. The plan targets digital infrastructure, care coordination, chronic disease and maternal health, workforce development, sustainability, and rural technology innovation. The state requests $1 billion in federal funding to modernize infrastructure and improve health outcomes across rural communities.
Budget Narrative
This document is South Carolina’s amended RHTP application budget narrative detailing a $1 billion funding strategy under the Rural Health Transformation Program. Funds support five major initiatives—Connections to Care, Leveling Up, Wellness Within Reach, Shoring Up to Sustainability, and the Tech Catalyst Fund—through subrecipient and contractor awards focused on rural health IT modernization, chronic disease management, workforce incentives, facility enhancements, community paramedicine, crisis response, and network and financial sustainability. The budget displays detailed plans for allocation, compliance, and accountability over a five-year implementation period.
See the full RHT grant application package.
This application details New Mexico's comprehensive Rural Health Transformation Program (RHTP) plan and initiatives, including workforce development, health analytics, community-led innovation, financial solvency, and expanded access to specialty and chronic care for rural, frontier, and tribal populations. The plan focuses on five core initiatives and aims for measurable improvements in access, health outcomes, and sustainability. The New Mexico Health Care Authority will lead implementation with guidance from a broad Stakeholder Advisory Committee and collaborative partnerships.
CMS Application Overview
This document is Virginia’s official application to the Rural Health Transformation Program, submitted to CMS on November 5, 2025. It outlines a $1 billion, five-year state plan called 'VA Rural Vitality' detailing strategic initiatives to modernize technology, build workforce pipelines, expand rural care access, and promote healthy lifestyles. The plan includes collaboration with a range of partners and awaits CMS funding determination by December 31, 2025.
CMS Application
This document is Virginia's official Rural Health Transformation Program (RHTP) application to CMS, proposing the VA Rural Vitality set of initiatives targeting rural health transformation statewide. The application describes strategic goals and objectives aligned with RHTP priorities, including improving access, outcomes, workforce development, and ensuring provider financial stability. It provides demographic analysis, stakeholder findings, detailed performance targets, and specific milestones for implementation.
Download the Full Version of Tennessee's Rural Health Transformation Plan
This document is Tennessee's application for the CMS Rural Health Transformation Program (RHTP), outlining a comprehensive, statewide rural health transformation strategy under the One Big Beautiful Bill Act. The plan includes substantial investments in rural hospital right-sizing, workforce pipeline development, enhanced EMS and community paramedicine, health IT modernization, and financial sustainability models. It includes data-driven goals, performance targets through FY2031, and details on alignment with RHTP federal priorities.
Approved Budget Period 1 Revised Project Narrative
The Rural Texas Strong project outlines the state's comprehensive application to the Rural Health Transformation Program under the One Big Beautiful Bill Act. It details Texas's strategies to transform rural healthcare, including workforce development, infrastructure upgrades, technology adoption, and financial stabilization for rural hospitals and providers across 202 rural counties. The application sets clear performance goals, strategic initiatives, and aligns with federal RHTP objectives to improve access, health outcomes, and sustainability for rural Texans.
Budget Period 1 Revised Project Narrative
Rural Texas Strong is the state's comprehensive RHTP application to CMS, targeting transformation in 202 rural counties and serving nearly 3.7 million rural residents. It sets strategic goals around access, technology, partnerships, workforce, and financial solvency, with measurable performance targets through FY2031. Main initiatives emphasize AI and telehealth, chronic disease prevention, workforce development, cybersecurity, and capital investments for rural hospitals and providers.
Project Narrative
This document is South Carolina's RHTP application, outlining a comprehensive plan for rural health transformation. Five major initiatives focus on digital infrastructure, chronic disease management, workforce recruitment and retention, provider technology upgrades, and health outcomes improvement. The application addresses systemic barriers, details targeted investments, and aligns with RHTP's strategic goals, aiming for measurable transformation by FY2030.
application here
This document is the Oklahoma State Department of Health's full application to the CMS Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. It outlines ambitious, multi-pronged strategies to address rural health needs statewide—focusing on facility financial stabilization, shifting to value-based payment, expanding telehealth and data utility, and robust workforce development. By FY 2031, Oklahoma aims to transform rural care delivery, access, and outcomes via the coordinated six-initiative RHTP framework, aligned to CMS goals.
Rural Health Transformation Program application
This document is Nevada's official application for the Rural Health Transformation Program (RHTP), proposing a comprehensive plan to address rural health disparities under CMS funding. The application outlines the state's strategic goals, major multi-year initiatives, specific funding allocations, and detailed targets for workforce development, access to care, and health equity in rural and frontier Nevada. Proposed uses include care delivery innovations, workforce expansion, and significant investments in technology to improve rural health outcomes through 2031.
RHTP Plan
This document is Montana's official application for the Rural Health Transformation Program (RHTP), submitted in February 2026. It details a comprehensive, multi-initiative plan to improve rural workforce development, facility sustainability, care delivery innovation, technology adoption, and population health for Montana's rural and Native communities. The plan sets specific performance targets through FY2031 and describes strong public and private partnerships to achieve rural health transformation.
Minnesota Rural Health Transformation Program Project Narrative (PDF)
This Minnesota RHTP grant application details a statewide plan for rural health transformation, focused on five strategic goals that align with CMS priorities. The plan targets increased telehealth capacity, improved provider retention, chronic disease prevention and management, workforce development, technology adoption, and financial viability for rural hospitals, clinics, Tribal health, and FQHCs. It outlines performance metrics, eligible counties, population focus, key partner organizations, and major initiatives to enhance care delivery, access, and sustainability under the Rural Health Transformation Program.
RHTP Project Narrative*
This document is California's Rural Health Transformation Program (CA-RHT) application, outlining the state's comprehensive rural health transformation strategy under the Rural Health Transformation Program (RHTP). It details demographic factors, strategic goals, workforce and technology initiatives, regional hub-and-spoke care models, and milestone-based transformative payments to rural hospitals, with focused attention on high-need populations and Tribal communities. The application substantiates California's request for RHTP support and provides a roadmap for improving rural health access, quality, and provider sustainability.
Rural Texas Strong – Project Narrative and Other Supporting Materials
This is Texas' statewide application for the Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act, as the 'Rural Texas Strong' initiative. The document outlines comprehensive, RHTP-funded strategies and milestones across technology, workforce, financial solvency, population health, and infrastructure to transform rural health systems, address rural hospital vulnerability, and improve Medicaid and population health outcomes. The application includes explicit RHTP strategic goals, targeted activities, a detailed performance framework, and eligibility criteria for rural hospitals and partners.
Rural Texas Strong Project Narrative
This document is the Texas statewide application for funding under the Rural Health Transformation Program (RHTP), as authorized in the One Big Beautiful Bill Act. The plan lays out a comprehensive multi-year transformation strategy called Rural Texas Strong, designed to improve population health, workforce, financial solvency, and technology infrastructure across all 202 rural Texas counties and serves 93 Critical Access Hospitals. It provides explicit objectives, initiatives, and program performance measures aligned with RHTP requirements.
Other Attachments
This document is a letter of support and program duplication assessment for South Carolina's application to the Rural Health Transformation Program (RHTP), submitted under Funding Opportunity CMS-RHT-26-001. It details broad stakeholder engagement and outlines the plan's focus on improving access to quality health care, especially chronic disease management, in rural areas. The South Carolina Department of Health and Human Services is designated as the lead agency and will oversee application, administration, and implementation.
Utah's RHTP Application Summary
This document is Utah's formal application for the Rural Health Transformation Program (RHTP), outlining its strategic goals, planned initiatives, and approach to transforming rural health outcomes statewide. Utah's RHTP aims for sustainable improvements in access, quality, outcomes, and workforce development through seven broad initiatives addressing everything from preventive health to health IT and financial models. The application details state-level policy actions, stakeholder engagement, key deadlines, and alignment with CMS funding requirements.
RFI 26-630-0900-0011 Rural Health Transformation Program(PDF)
This Request for Information (RFI) from the New Mexico Health Care Authority solicits public input on the development of New Mexico's Rural Health Transformation Plan to support its application for the Rural Health Transformation Program (RHTP) under the One Big Beautiful Bill Act. It details eligible activity types, strategic goals, target populations, funding limits, and the intended competitive application process with key dates for state stakeholders. The document also describes federal and state policy actions relevant to the program and seeks specific, scalable project proposals that will improve access and outcomes for rural and frontier New Mexicans.
Letters of support
This document consists of multiple letters of support from statewide and regional partners for Rhode Island's application to the Rural Health Transformation Program (RHTP) under CMS Funding Opportunity Number CMS-RHT-26-001. Partner organizations commit to several key initiatives, including workforce development, payment reforms, EMS infrastructure enhancements, behavioral health expansion, and telehealth modernization as part of Rhode Island’s Rural Health Transformation Plan. The letters highlight Rhode Island's collaborative approach and readiness to implement transformative projects to improve rural health outcomes, access, and system sustainability.
State of Maine RHTP Project Narrative (PDF)
This is Maine's official application to the Rural Health Transformation Program (RHTP), outlining a statewide transformation strategy to improve access, quality, workforce, technology, and financial sustainability for rural health systems. The plan centers on five major initiatives, including population health, workforce development, technology innovation, health care access, and hospital financial stability, with a focus on value-based care and collaboration among key partners. The proposal details performance targets and comprehensive strategies to deliver impactful improvements for rural Mainers across multiple dimensions of health and healthcare delivery.
Application for Federal Assistance
This is a federal application from the South Carolina Department of Health and Human Services submitted to CMS under the Rural Health Transformation Program (CMS-RHT-26-001). The project, titled 'Transforming Rural Healthcare in South Carolina,' seeks $1,000,000,000 in federal funding for rural health transformation activities statewide from 2025 to 2030. No additional program strategy, partners, or details are provided in this extracted content.
RHTP Project Narrative
This is the State of Alaska's official application to the CMS Rural Health Transformation Program (RHTP), detailing Alaska's challenges, target populations, strategic goals, and transformation initiatives in rural, remote, and frontier health care. The proposal explicitly aligns with RHTP objectives and lays out concrete initiatives for workforce, financial, technological, and population health transformation under the One Big Beautiful Bill Act. The application reflects substantial partnerships and detailed performance objectives for statewide rural health care improvement.
RHT Program State Project Abstracts
This document compiles State-level abstracts from Rural Health Transformation Program (RHTP) applications submitted in December 2025. Each abstract summarizes the purpose, anticipated outcomes, major partners, and proposed program activities to be implemented with RHTP funds under the federal initiative. The document presents illustrative budgets, details of transformation plans, and a wide array of strategic approaches but is intended for public information and does not reflect final awards.
See Tennessee Gov. Bill Lee's Announcement of Tennessee's Proposal
On November 5, 2025, Tennessee submitted its application to access Rural Health Transformation Program (RHTP) funding established by the One Big Beautiful Bill Act. The proposal details five transformation goals, emphasizing modernization, value-based care, maternal health, prevention, health technology, and workforce development. The application builds upon existing state-led rural health initiatives and partnerships.
Disclosure of Lobbying Activities
This document is a lobbying disclosure associated with the South Carolina Department of Health and Human Services' application or participation in the Rural Health Transformation Program, as administered by CMS. It is linked to a federal grant or award process under the program.
HR 1, the One Big Beautiful Bill Act (OBBBA)
This federal statute establishes the Rural Health Transformation Program (RHTP), appropriating $50 billion for state transformation plans to support rural hospitals and providers from FY2026-2030. States must submit detailed transformation plans to CMS by December 31, 2025 to access funding for quality improvement, workforce, technology, and sustainable rural health care delivery. The law sets out eligibility, allotment formulas, permitted activities, and strategic priorities for RHTP funding.
H.R. 1 Section 71401
The document establishes the Rural Health Transformation Program (RHTP), a $50 billion initiative appropriated for FY2026-2030. It outlines state eligibility requirements, transformation plan components, authorized activity types, milestones, the distribution and use of funds, and financial provisions. The program's primary focus is on rural health systems, with substantial emphasis on hospitals, technology, workforce, and access.
Presentation on Rural Health Transformation Program to Budget Section
This document outlines the North Dakota implementation approach, timeline, and funding breakdown for the Rural Health Transformation Program under OBBBA. It details baseline and workload funding expectations, application deadlines, and strategic goals for North Dakota's RHTP participation. The program supports major investments in rural health access, workforce, and care innovation statewide.
Slides
This document is a Centers for Medicare & Medicaid Services (CMS) Notice of Funding Opportunity (NOFO) Webinar for the Rural Health Transformation (RHT) Program, a $50 billion federal initiative established by the One Big Beautiful Bill Act. It provides an overview of eligibility, application components and requirements, scoring, funding allocation, and strategic goals for state-level rural health transformation plans. It specifies critical processes and timelines for state applications and outlines expectations for reporting, evaluation, and sustainability.
CMS FAQ - Updated October 2025
This FAQ provides substantive guidance for States applying to the Rural Health Transformation Program (RHTP) as authorized by Public Law 119-21 and the One Big Beautiful Bill Act. It specifies eligibility, application process, technical assistance, use of funds, and the structure of State applications for RHTP's five-year cooperative agreement program. Guidance includes award process, budget instructions, reporting, permissible initiatives, and requirements for engaging partners and stakeholders.
Frequently Asked Questions—April 2026
This FAQ document provides post-award guidance for states participating in the Rural Health Transformation Program (RHTP) under CMS oversight. It covers budget management, reporting requirements, allowed changes to initiatives, and workforce-related provisions including rural service obligations and non-compete restrictions. Key reminders include strict use of funds, checkpoint-based progress assessment, and ongoing compliance with CMS review procedures.
RHT Program Reporting and Rescoring Webinar_02.25.26
This draft CMS webinar provides detailed guidance on RHT Program state-level annual and quarterly reporting requirements. It outlines program timelines, required templates, the rescoring process for funding decisions, and the shift from Excel to a web-based reporting tool for states. No specific state- or initiative-level data is included, as this is a general federal instructional document.
CMS 5 Year Commitment Fact Sheet
This document provides guidance on Category E Workforce Initiatives under the Rural Health Transformation Program (RHTP), specifically detailing the 5-year rural service commitment required for certain recruitment and retention awards. It outlines allowable and unallowable uses of RHTP funds for workforce infrastructure and individual incentives, including how the 5-year requirement applies and how states may manage, track, and report compliance. Several example scenarios and compliance rules are included to assist states in program administration.
Rural Health Transformation (RHT) Program | CMS
RHTP Milestones
Year 1
Sub-awardee and Contractor Identification
The State begins identifying sub-awardees and contractors to implement initiatives.
↳ See the full RHT grant application package.
FY2026
RHTP Launch
RHTP funding allocation begins for states.
↳ Rural Health Transformation Program
FY2026
Baseline Data Collection
Begin collection of baseline rates for performance objectives using RHTP funding.
↳ State of Maine RHTP Project Narrative (PDF)
2032-10-01
Unexpended funds return
Unexpended or unobligated funding as of this date will be returned to the Treasury.
↳ CMS Notice of Funding Opportunity (NOFO) for RHT Program
2032-10-01
Return of Unused Funds
Any unused RHTP funds leftover as of this date will be returned to the Treasury.
↳ https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2025/rural-health-transformation-program-summary.pdf(link is external)
2032-09-30
Final Expenditure Deadline
All RHTP funds must be expended by September 30, 2032.
↳ H.R. 1 Section 71401
2031-02-27
Final Progress Report Due
Final progress report due for Arizona's RHTP award.
↳ Arizona’s Notice of Award 12/29/25
2031-02-27
Final Progress Report Due
Final report due 120 days after end of period of performance.
↳ Notice of Award Dec. 29, 2025
2031-02-27
Final Progress Report Due
Final cumulative progress report deadline.
↳ Nevada's RHT Program Notice of Award (NOA)
2031-02-27
Final Report Due
Overall, cumulative program report covering FY26 to FY31 is due.
↳ RHT Program Reporting and Rescoring Webinar_02.25.26
2031
Program Completion
Nevada aims to meet RHTP transformation targets by the end of FY2031.
↳ Revised Project Narrative - 01.30.2026
2031
End of Performance Period
Target date for achieving Rural Texas Strong key performance objectives.
↳ Approved Budget Period 1 Revised Project Narrative
Site Activity
This draft CMS webinar provides detailed guidance on RHT Program state-level annual and quarterly reporting requirements. It outlines program timelines, required templates, the rescoring process for funding decisions, and the shift from Excel to a web-based reporting tool for states. No specific state- or initiative-level data is included, as this is a general federal instructional document.
Apr 15, 2026 22:41
This fact sheet provides guidance on allowable and unallowable uses of Category B Provider Payments under the Rural Health Transformation Program. It outlines restrictions, sustainability requirements, and the 15% cap on Category B funding, as well as allowable example expenditures tied to state RHT transformation plan initiatives. The document clarifies payment models and directs states to ensure RHTP funds do not duplicate existing programs.
Apr 15, 2026 22:41
The Rural Health Transformation Program (RHTP), a $50 billion initiative authorized by the One Big Beautiful Bill Act, aims to transform rural healthcare nationwide by supporting state-based innovation, sustainability, workforce development, care coordination, and technology advancement. The program will fund approved states from FY2026 to FY2030, with application and award timelines set for late 2025. Strategic goals include improving rural health access, fostering tech solutions, and enabling innovative care and workforce models.
Apr 15, 2026 22:41
This document compiles State-level abstracts from Rural Health Transformation Program (RHTP) applications submitted in December 2025. Each abstract summarizes the purpose, anticipated outcomes, major partners, and proposed program activities to be implemented with RHTP funds under the federal initiative. The document presents illustrative budgets, details of transformation plans, and a wide array of strategic approaches but is intended for public information and does not reflect final awards.
Apr 15, 2026 22:41
This is a high-level summary, prepared by the CMS Office of Rural Health Transformation, of multiple state applications for FY2026 funding under the Rural Health Transformation Program. Each state outlines strategic priorities such as digital and telehealth innovations, workforce expansion, care coordination, maternal and chronic disease health improvement, and rural hospital and EMS support, anticipating measurable improvements in rural healthcare access, outcomes, and delivery.
Apr 15, 2026 22:41
This FAQ document provides post-award guidance for states participating in the Rural Health Transformation Program (RHTP) under CMS oversight. It covers budget management, reporting requirements, allowed changes to initiatives, and workforce-related provisions including rural service obligations and non-compete restrictions. Key reminders include strict use of funds, checkpoint-based progress assessment, and ongoing compliance with CMS review procedures.
Apr 15, 2026 22:41
US RHTP site updated — 90 new doc(s)
Apr 15, 2026 20:57