As of October 1, 2025, federal budget negotiations have led to a temporary government shutdown, prompting healthcare leaders to monitor potential impacts on programs administered by the Centers for Medicare & Medicaid Services (CMS). While federal agencies have contingency plans in place, to date CMS has not announced any potential impacts, including to the timelines for the application and award dates for the Rural Health Transformation (RHT) Program.
State governments and healthcare leaders should continue to develop and prepare to submit their applications for the RHT program, which provides a significant opportunity to revitalize rural healthcare infrastructure through strategic investments in access, workforce, innovation, and technology.
Strategies for States to Efficiently Develop Winning Applications
To maintain momentum and optimize their resources during this period of uncertainty in federal government funding and operations:
1. Strengthen Internal Coordination
- Establish cross-agency working groups to manage RHT program planning and execution
- Use internal policy experts to interpret the Notice of Funding Opportunity (NOFO) guidance and align initiatives with CMS priorities
2. Leverage Existing Data and Evidence
- Use state-level health data to identify high-impact areas for investment
- Prioritize initiatives that align with the RHT program’s five strategic goals:
- Prevention and chronic disease management
- Sustainable access
- Workforce development
- Innovative care models
- Technology innovation
3. Utilize Project Management Tools
To support strategic planning and initiative tracking, Health Management Associates (HMA) is offering a free RHT Project Management Tool. This resource helps states:
- Organize and manage initiative development
- Cross-reference projects with NOFO categories
- Track progress and performance metrics
- Facilitate collaboration across stakeholders
Access the RHT Project Management Tool from HMA:
Complete the form to download
the RHT Project Management Tool
Engage with CMS Resources Proactively
States and their partners can continue to refer to key CMS resources:
States can also submit questions to [email protected].
Final Thoughts
While the government shutdown presents challenges for many federal programs, it remains unclear whether there will be any direct impact on CMS’s engagement with states regarding the Rural Health Transformation Program. Regardless of federal circumstances, this moment highlights the value of state-level leadership and innovation. By leveraging tools like HMA’s project management platform and aligning with CMS’s strategic goals, states can continue advancing rural health transformation and position themselves for success, even in uncertain times.