Rural Health Transformation Program: What Rural Clinics Need to Know

The Rural Health Transformation (RHT) Program represents one of the largest federal investments in rural healthcare in U.S. history.

Authorized under Public Law 119-21, the program provides $50 billion over five years to help states improve healthcare access, strengthen rural workforces, modernize technology, support chronic disease management, and develop more sustainable models of care. Funding began in fiscal year 2026 and will continue through fiscal year 2030. 

All 50 states received awards in December 2025, and implementation is now underway. Rural clinics do not apply directly to CMS for RHT funding. Instead, they should monitor the programs, grants, and RFPs being developed by their state and identify where their organization aligns with state priorities.

Clinics can prepare by reviewing their state’s RHT plan, engaging with the agency administering the program, identifying measurable challenges they want to address, and building relationships with potential technology and healthcare partners. Organizations should also consider how proposed investments will remain sustainable after the initial funding period.

With states already rolling out funding opportunities, clinics that understand their needs and can clearly demonstrate how an initiative supports better access, outcomes, efficiency, or chronic disease management may be better positioned to participate.

What Is the Rural Health Transformation Program?

The Rural Health Transformation Program was created to address persistent challenges facing rural healthcare, including limited access to services, workforce shortages, technology gaps, financial pressures, and the growing burden of chronic disease. States are being encouraged to invest in programs that can make rural care more accessible, efficient, connected, and sustainable over the long term.

Rather than distributing funding directly to individual clinics, CMS awards funding to states. Each state then develops and implements its own rural health transformation strategy.

CMS has organized the program around five broad goals:

• Improving rural health: Supporting prevention, chronic disease management, behavioral health, prenatal care, and other evidence-based interventions.
• Creating sustainable access: Helping rural providers operate more efficiently and coordinate services with other healthcare organizations.
• Strengthening the workforce: Recruiting and retaining clinicians while making better use of pharmacists, community health workers, navigators, and other healthcare professionals.
• Developing innovative care models: Supporting coordinated care, value-based arrangements, and new ways to provide healthcare outside traditional settings.
• Advancing technology: Expanding remote care, data sharing, cybersecurity, interoperability, and other digital health capabilities. ¹

How Much Funding Is Available?

The RHT Program provides $10 billion annually from fiscal year 2026 through fiscal year 2030, for a total of $50 billion.

Half of the annual funding is distributed equally among approved states. The other half is allocated based on factors such as rural population, rural healthcare infrastructure and facility needs, and other criteria established by CMS.²

For fiscal year 2026, state awards averaged approximately $200 million, ranging from roughly $147 million to $281 million. ³

That gives states considerable flexibility to pursue initiatives based on the specific needs of their rural communities.

What Can Rural Health Transformation Funds Be Used For?

For clinics, some of the program’s most notable opportunities involve chronic disease management and technology-enabled care. 

CMS has specifically highlighted investments in telehealth, remote patient monitoring, digital tools, interoperability, and clinical workflow technology as part of states’ rural transformation efforts. ⁴

These priorities are particularly significant for rural organizations already considering how to improve care between visits, expand patient monitoring, or support more patients without proportionally increasing staff.

Key Rural Health Transformation Program Dates

The initial federal application process has already concluded, but understanding the timeline helps clinics determine where the program stands today. States are responsible for implementing their approved plans and distributing funding through state-specific initiatives. 

The National Rural Health Association maintains a tracker of state RFPs and other funding opportunities, including open dates, due dates, award dates, and anticipated project start dates. Because each state controls its own procurement process, clinics should also verify opportunities directly with their state agency. 

What Does the RHT Program Mean for Rural Clinics?

The program could give rural providers an opportunity to address challenges that are difficult to solve through incremental investments alone.

1. More opportunities to expand care beyond the clinic

Distance has always been one of rural healthcare’s biggest barriers.

Remote patient monitoring, digital communication, and other forms of technology-enabled care can give providers more visibility into what is happening with patients without requiring every interaction to happen in the clinic.

The RHT Program specifically allows states to invest in remote monitoring and technology solutions that improve care delivery. ⁵ 

2. Greater emphasis on chronic disease management

Patients with chronic conditions require support between office visits, but rural practices often have fewer people available to provide that support.

RHT funding explicitly supports measurable interventions for prevention and chronic disease management, making this a central opportunity for clinics looking to develop more proactive care models. ⁶

Instead of relying primarily on episodic office visits, rural organizations may have more resources to monitor patients over time, identify changes earlier, and intervene before conditions become more serious.

3. Technology investments should reduce administrative burden

New funding does not automatically create additional capacity.

A rural clinic can add technology and still struggle if that technology requires staff to manually review multiple systems, track activities, document interactions, or manage disconnected workflows.

The strongest RHT investments will likely be those that allow existing teams to care for more patients more effectively.

CMS itself has highlighted clinical workflow technologies alongside remote monitoring, interoperability, and digital tools as potential ways to reduce burdens on clinicians. ⁷

4. Sustainability will matter after the grant period

The RHT Program is a five-year investment, but rural healthcare organizations need care models that remain financially viable well beyond 2030.

That makes sustainability an important consideration when evaluating potential projects.

Technology should not simply satisfy the requirements of a temporary grant. It should help clinics create an operating model that can continue supporting patients after the initial funding ends.

For care management, that can mean combining improved patient outcomes with programs that appropriately reimburse providers for ongoing care.

5. Documentation and measurable outcomes will become increasingly important

RHT funding comes with oversight, milestones, and reporting expectations. CMS has established checkpoints for state initiatives, and future funding can be affected by states’ ability to meet program requirements.

Clinics participating in state-funded projects should therefore expect measurement to be part of the equation.

Before committing to an initiative, organizations should understand how they will demonstrate patient engagement, clinical activity, program utilization, outcomes, and other measures required by their state.

What Should Rural Clinics Do Now?

Organizations should use this time for preparation rather than waiting for another federal application period.

Clinics should:

1. Understand their state’s RHT priorities. Review your state’s approved plan and identify where your clinic aligns with its priorities, such as chronic disease management, preventive care, workforce capacity, remote care, value-based care, or technology modernization. Across states, common priorities include chronic disease management, workforce stabilization, innovative care models, telehealth, interoperability, and cybersecurity.
2. Monitor state funding opportunities closely. States are releasing their own RFPs and other funding opportunities on different schedules. NRHA maintains a state-by-state tracker showing open opportunities, deadlines, award dates, and anticipated project start dates.
3. Build relationships with the state agency administering the program. Clinics should identify their state’s RHT lead agency and stay engaged with its announcements, informational sessions, stakeholder meetings, and procurement notices. States are currently identifying vendors, implementation partners, and grant recipients to carry out their approved plans.
4. Define a measurable problem you can help solve. Instead of approaching RHT funding as simply a way to purchase technology, clinics should be prepared to demonstrate a specific need and outcome—for example, improving chronic disease management, increasing access between visits, reducing avoidable hospital utilization, or making care delivery more efficient. CMS emphasizes evidence-based, outcomes-driven interventions throughout the program.
5. Identify partners before an opportunity opens. Some initiatives may favor regional or collaborative approaches rather than individual clinics working alone. CMS specifically encourages rural facilities to coordinate operations, technology, primary and specialty care, and other services with neighboring providers or regional health systems.
6. Be ready to demonstrate sustainability. RHT funding runs through FY2030, so clinics should think beyond the initial grant. Projects that improve efficiency, support sustainable access, and create care models that can continue after the funding period are closely aligned with the program’s goals.

The National Rural Health Association’s state activity resources can also help organizations track funding opportunities, but deadlines and requirements should always be confirmed with the responsible state agency. ⁸

Turning Rural Health Transformation Into Sustainable Care

The Rural Health Transformation Program creates a significant opportunity for rural clinics to rethink how they care for patients with chronic conditions.

Transformation, however, requires more than funding.

It requires giving care teams the visibility and tools to identify patients who need attention, stay connected between office visits, document care efficiently, and create financially sustainable programs without adding unnecessary work.

ChronicCareIQ helps healthcare organizations do exactly that.

Our connected care management platform brings patient monitoring, engagement, documentation, and reimbursement workflows together so care teams can spend less time managing administrative work and more time supporting patients.

For rural practices exploring how RHT investments could support chronic care management, remote patient monitoring, and more proactive care between visits, ChronicCareIQ can help turn a short-term technology investment into a sustainable care management strategy.

Talk to ChronicCareIQ about building a more scalable rural care management program.

References: 

1. Medicaid
2. Medicaid
3. Centers for Medicare & Medicaid Services
4. Centers for Medicare & Medicaid Services
5. Medicaid
6. Medicaid
7. Centers for Medicare & Medicaid Services
8. National Rural Health