As of November 5th, states have submitted their applications for the Rural Health Transformation Program (RHTP) – a major federal initiative aimed at addressing persistent healthcare challenges in rural communities. Authorized by the 2025 budget reconciliation bill (OBBBA), the RHTP will distribute $50 billion over the next five years to help rural communities improve healthcare access, quality, and outcomes. All 50 states are eligible.
This submission marks a key milestone, but it’s just the beginning. The Centers for Medicare & Medicaid Services (CMS) is reviewing applications, and ongoing conversations between states and CMS will shape the final design and implementation of each state’s program. Awards are expected by December 31, 2025, and states – and their partners – must be ready to move quickly early in 2026.
States must now prepare for a fast-moving design and implementation phase, building on initiatives already underway and refining plans and budgets based on CMS feedback. States will need to staff up quickly and launch new projects in early 2026. With tight fiscal timelines and the risk of forfeiting funds, agencies and community organizations must act decisively. It will be crucial to demonstrate impact on health outcomes within the first half of 2026 will be critical.
Organizations across the healthcare industry should closely monitor how states plan to operationalize their proposals, as these strategies will shape funding flows and partnership opportunities.
Many state agency leaders will be attending the National Association of Medicaid Directors (NAMD) annual conference November 18-21, 2025. The RHTP applications will be a big topic of conversation, with states sharing ideas and stakeholders discussing challenges and opportunities that could be addressed with RHTP funding. HMA will have a strong presence at NAMD and will be gathering important insights on the federal expectations, program content, and operational strategies that states put in their applications.
Organizations interested in learning more about their state’s direction – or in becoming part of the implementation conversation – can reach out to HMA experts listed below.
What’s next with the RHTP?
Any state that is approved for RHTP funding requires:
- A strong management structure at the state level, including dashboards and oversight of programs funded through this award
- Defined goals and sustainable initiatives in chronic disease management, primary care, behavioral health, maternal health, digital innovation, workforce initiatives, and other topics
- Demonstrated outcomes that evidence improvements in rural access and health outcomes, as well as the care experience of rural residents
HMA is ready to help. Our team brings deep expertise in tackling the complex challenges of delivering quality healthcare and human services to rural communities. We understand the challenges rural providers face—from workforce shortages and service gaps to transportation hurdles and socio-economic barriers—and can help states and organizations navigate complexities of implementation.
With broad experience, HMA is a national leader in healthcare consulting, with a multidisciplinary team of over 700 experts experienced in policy, finance, clinical services, analytics, and community engagement. We help rural organizations act decisively and efficiently, meeting the strict deadlines set by the RHTP and minimizing risks such as funding claw-backs. From actuarial and financial skills to clinical and operational expertise, policy, and analytics, HMA can support successful implementation of your State’s Rural Health Transformation program.
Related resources:
- Rural Health Transformation Program Represents a One-Time Opportunity to Reshape Rural Care
- HMA knows rural.
- The Rural Health Transformation Program: Options to Address the Maternity Care Crisis
- HMA toolkit and webinar to advance health equity & access for rural dually eligible individuals
- HMA’s Experts Support States in Rural Health Initiatives
