Program Overview
The Federal Rural Health Transformation Program (RHTP), authorized by federal law, is a $50 billion initiative supporting rural health system transformation across all 50 states from FY2026 to FY2030. The program is in its application phase, focusing on rural hospital stabilization, workforce recruitment and retention, technology advancement, evidence-based health interventions, and expanding access to care through innovative models. States must submit comprehensive transformation plans, achieve established milestones, and meet annual reporting requirements. Current structured plan tracks 11 key initiatives and 12 strategic goals.
Updated
County-level estimates averaged across Federal — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
46,345,066 rural residents
AI source: US - 2025 - Accessing Funding for Capital Projects in Rural Healthcare.pdf
AI auto-updated May 8, 2026
API refreshed May 8, 2026
Key signals are summarized here. Open the source for the supporting detail.
RHTP funding award amounts have been sourced from CMS, indicating that federal awards have been announced and initial distributions identified to states. Informal public references show subrecipients such as UNMC Dentistry are already using federal funds to address rural needs under RHTP. These developments confirm that state-level procurement activities have begun and funds are now being utilized in local projects.
The Federal RHTP strategy provides $50 billion in funding across FY2026–FY2030, directing states to implement evidence-based, outcomes-driven rural health transformation plans that address rural access, workforce, quality, and sustainability. States must allocate resources across multiple authorized priorities, including prevention, workforce recruitment, technology innovation, and new care models, with annual accountability and reporting required.
Model
Federally funded, state-led transformation requiring multi-year rural health plans focused on technology-enabled, partnership-based, and financially resilient interventions to improve rural health outcomes. States are responsible for implementing approved initiatives and adhering to program guidelines and eligibility criteria.
Key Initiatives (11)
Timeline: FY2026–FY2030 (one-time state application due by November 2025; funding distributed annually; annual progress and expenditure reporting required)
Focus on evidence-based interventions to improve prevention and management of chronic diseases in rural areas.
Supporting opioid and other substance use disorder treatment services as well as mental health care is required.
States are to bolster rural workforce pipelines and require multi-year service commitments to improve provider access.
Centers for Medicare & Medicaid Services (CMS)
Due May 15, 2026
3 related documents
US - 2026 - CMS RHTP
US - 2026 - CMS RHTP
US - 2026 - Home Resources For States RHT Program RHT Program RHTP Resources Image Transforming Rural Healthcare in America
Centers for Medicare & Medicaid Services (CMS)
Due Mar 1, 2026
3 related documents
US - 2026 - CMS RHTP
US - 2026 - CMS RHTP
US - 2026 - Home Resources For States RHT Program RHT Program RHTP Resources Image Transforming Rural Healthcare in America
Centers for Medicare & Medicaid Services (CMS)
Due Dec 31, 2025
2 related documents
US - 2026 - CMS RHTP
US - 2026 - Home Resources For States RHT Program RHT Program RHTP Resources Image Transforming Rural Healthcare in America
This document announces the FY2026 federal grant allocations for all 50 states under the CMS Rural Health Transformation Program, created by the One Big Beautiful Bill Act. Each state's RHTP award, totaling $10 billion across the US, supports rural health transformation initiatives spanning workforce, technology, population health, payment reform, and rural Medicaid.
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.
This fact sheet summarizes allowable and unallowable uses of Rural Health Transformation Program Category J funds for capital expenditures and infrastructure in rural health facilities. Examples of eligible expenses include minor renovations, equipment upgrades, repairs, accessibility improvements, and safety/security enhancements. Major construction or cosmetic upgrades are explicitly excluded, and total Category J spending cannot exceed 20% of a state’s RHTP award per budget period.
Core Initiatives
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.
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.
This policy paper analyzes capital access challenges facing rural hospitals and other rural health facilities. It presents an overview of major capital funding programs and historical trends, emphasizing the complexity of blended financing and persistent access barriers. The report highlights the importance of technical assistance, partnerships, and varied funding streams for sustaining and modernizing rural healthcare infrastructure.
Core Initiatives
State-by-state Medicaid Adult Core Set quality measure results for FFY2020 — 1,772 records across all 50 states and 27 measures spanning five domains, including chronic-disease-relevant measures like Controlling High Blood Pressure and Asthma Medication Ratio. A national baseline benchmarking source for state chronic-disease-focused RHTP initiatives.
Reference: Unmc Dentistry Using Federal Funds to Address Rural Needs Link: https://www.unmc.edu/newsroom/2026/08/11/unmc-dentistry-using-federal-funds-to-address-rural-needs/
FY2026
RHTP Launch
RHTP funding allocation begins for states.
↳ US - 2026 - Federal August 2025 RHTP Summary
2032-10-01
Return of Unused Funds
Any unused RHTP funds leftover as of this date will be returned to the Treasury.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2032-09-30
Final Expenditure Deadline
All RHTP funds must be expended by September 30, 2032.
↳ US - 2026 - H.R. 1 Section 71401
2031-02-27
Final Report Due
Overall, cumulative program report covering FY26 to FY31 is due.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
2030
Program Funding End
RHTP federal funding runs through FY2030.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2028-03-31
Unused Funds Redistribution
CMS will annually redistribute unused funds by this date.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2028-03-31
Redistribution Assessment Begins
CMS to determine unexpended/unobligated funds for redistribution annually beginning 2028.
↳ US - 2026 - H.R. 1 Section 71401
2028
Redistribution
Redistribution of unused state allotments for RHTP begins.
↳ US - 2026 - Federal August 2025 RHTP Summary
2027-09-30
Funds Expire for FY2026 Allotments
Funds distributed in FY2026 must be used by the end of FY2027.
↳ US - 2026 - Federal RHTP Summary 2026-2030
2027-08-30
Annual Report #2 Due
Second annual report is due, covering the following 12-month reporting period.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
2026-Q1
Monitoring Begins
Program monitoring and support for awardees begins in Q1 2026.
↳ US - 2025 - RHT Program Overview
2026-11-29
Quarterly Report #1 Due
First quarterly report for the RHT Program is due.
↳ US - 2026 - Federal Reporting And Rescoring Webinar February 25, 2026 RHTP
US RHTP site updated — 1 new doc(s)
US RHTP site updated — 1 new doc(s)
US canonical state summary updated: progressSummary updated · transformationStrategy updated · strategicGoals updated
US - 2025 - Rural Healthcare Capital Funding Analysis
US - 2026 - CMS RHTP
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed. Showing the 40 most recent of 83.
smd071901.pdf
cib060321.pdf
cib071917.pdf
The program is funded at $50 billion over five years (FY 2026-2030), with funding allocated equally and by need among states. States must use funds for at least three approved purposes including evidence-based health interventions, workforce recruitment, technology adoption, and innovating care models to promote sustainable rural health.
Event Schedule
Core Initiatives
The RHT Program is funded at $50 billion over five fiscal years (2026–2030) and supports innovative rural healthcare delivery, workforce development, technology advancement, and sustainable access to care. States must use funds toward multiple approved purposes, including evidence-based interventions, provider payments, tech-driven solutions, workforce recruitment/retention, and development of new service lines and care models. Program awards are distributed to states based on equal share and rural-related factors, with eligibility limited to the 50 U.S. states. Event schedule: - RHT Program Applicants Webinar - 09/19/2025 - Application Submission Opens - Mid-September 2025 - grants.gov - Application Submission Closes - Early November 2025 - Awards Announced - December 31, 2025
Event Schedule
Core Initiatives
This letter presents bipartisan Senate support for improving implementation of the Rural Health Transformation Program (RHTP). Senators urge CMS to enhance flexibility, prioritize direct and equitable funding for rural hospitals and clinics, and remove barriers to infrastructure investments and IT modernization. The recommendations aim to ensure RHTP fulfills its promise to strengthen rural health care in underserved communities.
Core Initiatives
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.
Event Schedule
Event Schedule
Core Initiatives
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.
Event Schedule
Core Initiatives
This CMS risk assessment template guides state Medicaid agencies in identifying, evaluating, and mitigating program integrity risks resulting from COVID-19 Public Health Emergency (PHE) waivers and flexibilities. The template offers a step-by-step process for documenting waivers, assessing inherent risks, prioritizing mitigation strategies, and maintaining a dynamic risk profile. While tailored for the COVID-19 PHE, it is adaptable for ongoing Medicaid and CHIP risk management needs and is not federally required but recommended.
QSO18-24-ESRD.pdf
CMS Medicaid/CHIP Risk Assessment Excel Template
XLSX
sho102221.pdf
sho22002.pdf
CIB-01-24-13.pdf
sho18008.pdf
allstatecall-20200616.pdf
sho-21-003.pdf
cib031819.pdf
sho20004.pdf
sho-21-002.pdf
SHO10003.pdf
smd16010.pdf
allstatecall-20200623.pdf
faq-01-16-2015.pdf
health-plan-strategy-12062021.pdf
cmcs-all-state-call-11092021.pdf
cib112816.pdf
US - 2026 - Medicaid Adult Core Set Quality Measures by State
HTML
US - 2026 - Unmc Dentistry Using Federal Funds to Address Rural Needs
US - 2026 - AHA CMS Should Remove Rhtp Funding Caps
US - 2026 - Rural Health Transformation Program Reporting
US - 2026 - 2026 08 05 AHA Comments Rural Health Transformation Program
US - 2026 - Rural Hospital Closures by State vs Transformation Funding
US - 2026 - Rural Health Transformation Efforts Offer an Opportunity for Pharmacy to Shine
US - 2026 - Senator Marshall Meets With Housing Energy Healthcare Professionals IN Southwest Kansas
US - 2026 - Senator Marshall Applauds 79 Million in Rural Health Dollars Awarded to Kansas Hospitals
US - 2026 - Senators Call 50B Rural Health Fund Better Target Small Providers Relax Spending
US - 2026 - MD, urging targeted adjustments to the RHT
US - 2026 - Governor Morrisey Announces 24 Million Investment Expand Worksite Clinics Across West
US - 2026 - Miller Meeks and EC Chairman Guthrie Tour Washington County Hospital Highlight
US - 2026 - Federal Landing Page (updated: June 23, 2026)
US - 2026 - Notice of Funding Opportunity (NOFO): RHTP Question and Answer Round 2 (OHS)
2026 Federal Poverty Guidelines
2026 · PDF
US - 2026 - Rural Tech Catalyst Fund Resource Guide
2026 · PDF
US - 2026 - Senators Collins, Bennet Lead Colleagues
2026 · HTML
HB 3066 - Health Care Workforce Training Commission; creating the Workforce Talent Recruitment Revolving Fund
2025-2026 · HTML