Rural Health Transformation Program (RHTP)

Summary

The Rural Health Transformation Program (RHTP), established under Section 71401 of Public Law 119-21 (OBBBA), dedicates $50 billion between FY2026 and FY2030 to transform rural healthcare delivery across all 50 states. RHTP is the largest federal investment in rural health since Medicare Modernization, supporting state-led innovation to stabilize and strengthen rural hospitals, enhance care access and provider sustainability, strengthen workforce capacity, coordinate care, and implement technology-driven solutions. Funds are distributed via cooperative agreements: half is divided equally among approved states; the other half is allocated on a formula considering rural population, proportion of health care facilities in rural areas, and hospital situations serving high shares of low-income patients. Each state receives at least $100 million annually; actual FY2026 awards range from $147 to $281 million. States must implement evidence-based interventions and sustainable rural provider models across at least three approved categories, including prevention, chronic disease management, workforce recruitment, and technology adoption.

Eligibility

Eligible applicants are State governments (all 50 U.S. States and the District of Columbia). Only one application per state will be accepted. States must propose statewide rural health transformation plans in accordance with Section 71401 of Public Law 119-21 (One Big Beautiful Bill Act).

Requirements Checklist

• Applicants must submit a comprehensive rural health transformation plan addressing statewide strategies for healthcare access, quality improvement, provider sustainability, technology upgrades, workforce development, care coordination, and population health. The application must include a project abstract, transformation plan narrative, budget justification, required assurances and certifications, a statement of compliance with federal reporting requirements, and evidence for at least three approved program purposes (e.g., prevention, chronic disease management, workforce recruitment, technology adoption). SAM.gov and Grants.gov registrations, including UEI, are required prior to submission.