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Special Sunday Bonus Edition: Resources for $50B Rural Health Transformation Funding Opportunity
Description
As you all know by now, CMS has launched one of the most ambitious rural-health initiatives in decades. The Rural Health Transformation (RHT) Program will distribute up to $50 billion through FY 2026-2030 to help states redesign how rural care is delivered—funding prevention, workforce pipelines, and digital access.
We’ve been digging into the details and getting as much insight to share as possible. On Friday of last week (10/10/25) we had a live Zoom call that included a slew of stakeholders from ag, food and healthcare. We have included the Zoom above. We plan to hold one more zoom this week.
In the meantime, we’ve created a shared drive where we will be updating information as it is received Google Drive. In addition to the program materials and state links and more, we have added a document DRAFT “State Language Framework - Crowd Source Document” that is designed to become a succinct set of language to be used to provide to your state officials or any other contacts helpful.
We welcome this group to “crowd source” this document but have some ground rules (some are redundant to details in the How To Engage section):
* MUST BE VENDOR AGNOSTIC
* Clearly articulate the scoring impact, specifying each measure and points
* Make it quantifiable (we are revising what we have created to do just that)
* MUST be sustainable without grant $$
* Please enhance and/or add new bullets/sections, don’t delete what is there
The specifics of what we suggest are found in the How To Engage Section below.
Who’s driving it
Health and Human Services (HHS) is leading the charge via Centers for Medicaid and Medicare (CMS), the HHS department responsible for program funding decisions and program oversight
* Alina Czekai, Director, Office of Rural Health Transformation
* Kate Sapra, Acting Deputy Director, focused on cross-state coordination
* Emily Chen, Senior Advisor, who urged evidence-based innovation, not pilot fatigue
* Christopher Clark, Grants Management Officer, who explained funding and compliance
Contact: MAHARural@cms.hhs.gov
“Rural transformation must move beyond keeping hospitals open. We’re building systems that keep people healthy where they live.” - Czekai
The timeline
Awards are expected by December 31, 2025.Funding begins January 2026, with five one-year budget periods running through FY 2030.Unspent funds can roll forward for one fiscal year before redistribution.
Key dates:
* Letter of Intent (optional) - Sept 30 2025
* Application deadline - Nov 5 2025 (11:59 p.m. ET)
* Awards announced - Dec 31 2025
* Budget Period 1 starts - Jan 2026
What states must deliver
Only states can apply directly, but CMS expects them to braid public and private resources. Each application must include:
* Needs Assessment – baseline data on rural access, chronic-disease burden, and facility status.
* Transformation Plan – clear goals and a sustainability model beyond federal dollars.
* Implementation Timeline – milestones through 2031.
* Stakeholder Engagement – Medicaid, tribal health, community providers.
* Evaluation Metrics – at least four measurable outcomes such as hospital readmissions, telehealth uptake, or A1C improvement.
“We’re not funding activities - we’re funding outcomes.” - Spara
Where Innovators