November 2025 Update: Rural Health Transformation (RHT) Program

The deadline for states to submit their applications for Rural Health Transformation (RHT) funds was November 5, 2025. Now, the Centers for Medicare & Medicaid Services (CMS) will review applications and announce awards by December 31, 2025. RHT will provide $50 billion to states with approved applications from 2026 through 2030. There will be $10 billion available every fiscal year during this period; 50% of this will be distributed equally among approved states, while the other 50% will be allocated by CMS based on individual state metrics, as well as the potential and scale of impact on rural health demonstrated in the applications.

With the application deadline passed and decisions regarding the amount of aid states will receive pending, rural health providers should use this time to finalize their internal preparations. Being proactive in this waiting period will help ensure safety-net providers are ready to act swiftly once funding decisions are released. These preparations should include:

Finalize and Refine Project Plans

• Think Long-Term: Make sure your plans show how you'll make lasting changes that stick around after the five-year funding ends. This isn't just about a quick fix; it's about building a sustainable future for your community's health.

• Collaboration: Rural health providers should explore partnership opportunities with local hospitals that receive awards, focusing on areas where strategic goals align. Proactive communication and joint planning can help leverage combined resources for a greater collective impact on the community's rural health.

• Prepare for reporting and evaluation: Develop clear metrics for tracking progress and demonstrating the impact of potential initiatives, as CMS will use data to assess states' progress. Having these systems in place will ease the burden felt when it is time to report data. 

Organize for Administrative Readiness

• Prepare for sub-awards: If the state's plan involves sub-awards, get ready for any Requests for Proposals (RFPs) or similar processes that the state may initiate after CMS announces awards. You want to be ready to receive funds as soon as possible. 

• Communicate with state officials: Stay in close contact with your state’s relevant agencies and ask what the state’s plan will be when decisions have been made. Being aware of how and when the state plans to distribute funds will be crucial to efficiently bring your plans to fruition.

These strategic preparations, and communication with the state regarding their plans for RHT funds, will be vital for efficiently securing and utilizing funds to build a sustainable future for rural healthcare in their communities.