Delivering high-quality rural healthcare services to underserved communities has been an enduring and under-addressed challenge in the United States. While different programs and schemes have been tried over several decades to improve access to care, results have been underwhelming. However, under the Working Families Tax Cuts Act passed in 2025, the Centers for Medicare and Medicaid has allocated $50 billion over 10 years to support investments in rural health transformation from digital infrastructure to workforce development.
In today’s news roundup we take a closer look at the Rural Health Transformation (RHT) Program and how some states are planning on using the funding to bring healthcare to underserved populations today, and for generations to come.
CMS Announces Rural Health Transformation Program
In September 2025, the Centers for Medicare and Medicaid (CMS) launched the Rural Health Transformation Program to drive generational change in how healthcare is delivered to rural and underserved communities across the United States. Delivering healthcare equitably to all Americans has been a seemingly intractable challenge, until now. The program “empowers states to strengthen rural communities across America by improving healthcare access, quality, and outcomes…through innovative system-wide change.”
States have a specific list of items for which they can use the funds they received in the December 2025 allocation and will receive each year for the next decade. These funds can be used for:
- Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
- Promoting consumer-facing technology-driven solutions for the prevention and management of chronic diseases.
- Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
- Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
- Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
To learn more about the Rural Health Transformation Program, click here.
Hawaiʻi Received $189 Million Dollars for Rural Health Transformation
Josh Green, Governor of Hawaiʻi, announced recently that the state had been awarded approximately $189 million through the Centers for Medicare and Medicaid Services’ Rural Health Transformation Program. The size of the award reflects “both the unique healthcare challenges facing its rural and neighbor island communities and the strength of the state’s rural health transformation strategy and application,” Green said. It is one of the largest value awards in the nation on a per capita basis.
Governor Green shared that “[t]his investment allows Hawaiʻi to finally close the distance between rural communities and the care they deserve.” With healthcare services concentrated in O’ahu, Hawaiʻi’s rural residents must travel at great cost to receive quality care.
Following a survey of residents and the healthcare community last year, Governor Green announced that RHT Program funds would be directed towards:
- Rural Health Information Network (RHIN) — A statewide digital backbone linking rural hospitals, clinics and health centers through interoperable electronic health records, wireless networks and shared data hubs.
- Pili Ola Telehealth Network — A statewide telehealth system connecting rural communities to providers while expanding virtual care and telehealth training.
- Rural Infrastructure for Care Access (RICA) — Expansion of emergency medical services, mobile healthcare, community paramedicine and behavioral health capacity in rural areas.
- HOME RUN (Hawai‘i Outreach for Medical Education in Rural Under-resourced Neighborhoods) — A workforce pipeline providing training, residencies, scholarships and mentoring to recruit and retain rural healthcare professionals.
- Rural Respite Network — Expansion of the medical respite model to rural communities to reduce avoidable hospitalizations among unhoused and post-acute patients.
- Rural Value-Based Innovation and AHEAD Readiness Fund — A competitive fund to help rural providers adopt innovative, value-based care models and prepare for CMS’ AHEAD payment system.
To learn more about Hawaiʻi’s rural healthcare transformation initiatives, click here.
Coming to Terms with the Promise and Realities of the Rural Health Transformation Program in Kansas
Like most funding programs these days, there’s a ‘but’ when it comes to the value that states can derive from the RHT Program. While the program is valued at $50 billion over the next 10 years and states will receive approximately $200 million each year to support rural healthcare in that timeframe, it also comes at the same time as the federal government will be eliminating $137 billion in funding from rural hospitals because of changes to Medicaid.
For the State of Kansas, the funding loss from changes to Medicaid hits particularly hard. As Cindy Samuelson, Senior Vice President of at the Kansas Hospital Association (KHA), noted during an interview on WBUR’s On Point, Kansas is one of the states with the “most at risk hospitals for closure.” In fact, Samuelson noted that the only reason many rural hospitals are staying open in Kansas is community support. “In Kansas, our hospitals rely on more than $78 million in additional county, city or district taxes to remain open,” she shared.
But with over $200 million in hand and a working plan with measurable outcomes in place created in partnership between the State of Kansas and KHA, Samuelson is confident that the RHT Program funding will make a big impact for Kansans. In particular, she noted that the transformation of delivery systems, attracting and retaining a skilled workforce, and how to foster innovative technologies to increase access to rural care are three of the five priorities for Kansas. By focusing on innovative technologies that drive efficiency for administrators and physicians and how they will affect patient outcomes, the future of rural healthcare in Kansas is looking bright.
