January 5, 2026
The Centers for Medicare & Medicaid Services (CMS) announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under the Working Families Tax Cuts legislation (Public Law 119-21) to strengthen and modernize health care in rural communities across the country.
In 2026, states will receive first-year awards from CMS, averaging $200 million, with a range of $147 million to $281 million. This federal investment will help states expand access to care in rural communities, strengthen the rural health workforce, modernize rural facilities and technology, and support innovative models that bring high-quality, dependable care closer to home.
The Rural Health Transformation Program is a national commitment to improving the health and well-being of rural communities across the country. With this funding, states will implement comprehensive strategies to improve care delivery, support providers, and advance new approaches to coordinating health-care services across rural communities. Across the country, many states are planning efforts that will:
Bring More Care Within Reach
States will advance Make Rural America Healthy Again goals by expanding preventive, primary, maternal, and behavioral health services, and creating new access points that bring care closer to home and help preserve strong local health systems. Many states are implementing evidence-based, outcomes-driven strategies—such as physical fitness and nutrition programs, food-as-medicine initiatives, and chronic disease prevention models—to address root causes of diseases and manage chronic conditions. States will also strengthen rural emergency care through improved emergency medical services (EMS) communication, treat-in-place options, and coordinated transfers.
Strengthen and Sustain the Rural Clinical Workforce
States will support clinical workforce training, residencies, recruitment and retention incentives, and new pathways that help students begin health-care careers in their own communities. States are also investing in programs to train and support the existing clinical workforce and build futures close to home.
Modernize Rural Health Infrastructure and Technology
Investments will modernize rural facilities and equipment; strengthen cybersecurity and interoperability; and expand telehealth, remote patient monitoring, and digital tools that enable timely access to care. States are also exploring the use of technology such as AI scribes and clinical workflow improvement tools to reduce burdens on clinicians.
Driving Structural Efficiency & Empowering the Community Providers
States will prioritize streamlining operations, empowering providers to enhance coordination of care and resources, and building partnerships across the state with the goal of keeping care local. This includes establishing specialized hub-and-spoke models, rural regional centers of excellence, comprehensive data-sharing platforms, and rural clinically integrated networks.
Advance Innovative Care Models and Payment Reform
States will test new primary care and value-based care models, strengthen partnerships among rural and other providers, and promote regional collaboration that improves health sustainability and patient outcomes.
The Rural Health Transformation Program’s $50 billion in funds will be allocated to all states over a five-year period, with $10 billion available each year from 2026 through 2030. As directed by Public Law 119-21:
- 50% of the funding is distributed equally among all states: This provides states with a strong foundation to begin implementing their Rural Health Transformation Plans.
- 50% is allocated based on a variety of factors: As described in the Notice of Funding Opportunity, those factors include individual state metrics around rurality and a state’s rural health system, current or proposed state policy actions that enhance access and quality of care in rural communities, and application initiatives or activities that reflect the greatest potential for, and scale of, impact on the health of rural communities. All scoring factors are outlined further in the Notice of Funding Opportunity.
The program follows standard HHS grants policy, including protections that ensure the integrity of the merit review process, consistent with longstanding HHS practices for competitive grant and cooperative agreement programs. Additional information on the Rural Health Transformation Program, including the Notice of Funding Opportunity, is available at http://www.cms.gov/RHTProgram.
To view the Rural Health Transformation Program State Project abstracts, visit https://www.cms.gov/files/document/rht-program-state-provided-abstracts.pdf.