The Rural Health Transformation (RHT) Program is a five-year, $50 billion initiative established under the One Big Beautiful Bill Act to strengthen healthcare delivery in rural communities. Beginning in 2026, the Centers for Medicare and Medicaid Services (CMS) will allocate $10 billion annually to states – half distributed equally among approved states and half based on factors such as rural population, facility distribution, and hospital conditions.
All 50 states submitted applications by the November 5 deadline, and CMS expects to announce funding decisions by December 31, 2025. While the level of detail CMS will release remains unclear, this program represents one of the most significant federal investments in rural health in decades.
States are proposing transformative strategies aligned with CMS’s five strategic goals:
For healthcare stakeholders, these initiatives will influence care delivery, payment structures, and technology adoption across rural markets. Understanding state priorities now is critical for identifying partnership opportunities, anticipating regulatory developments, and aligning strategic plans.
McDermott+ has developed a comprehensive document highlighting some of the most common proposals and strategic initiatives being pursued by states, as well as a spreadsheet tracking publicly available state applications and summaries.
These resources are available for M+ clients and McDermott+ Insider subscribers only. Learn more and request access to McDermott+ Insider below:
