NRHA Rural Health Transformation Program State Application Summary Guide
PRESS RELEASE
The National Rural Health Association
December 16, 2025
The Rural Health Transformation Program (RHTP), created under the One Big Beautiful Bill Act (Public Law No. 119-21), is a major new federal initiative to strengthen rural health care delivery and stabilize essential services. On November 5, 2025, states were required to submit their RHTP applications to the Centers for Medicare and Medicaid Services (CMS), outlining their intended use of funds to support and transform rural healthcare in their communities.
NRHA is proud to share our new Rural Health Transformation Program State Application Summary Guide to provide a picture of how states are designing and budgeting their initial transformation strategies. This guide serves as a resource on states’ intended use of RHTP funds. All information in this document is drawn from state applications and other publicly available sources. The proposals in these applications are pending CMS funding decisions that will be released no later than December 31, 2025.
Early trends show a strong focus on health workforce stabilization, prevention and chronic disease management, and value-based and innovative care models. Many states focus on strengthening rural systems for resilience through hospital sustainability, EMS modernization, mobile and community-based service delivery, and models with regional support and local delivery. Technology modernization through consumer-facing tools, telehealth, interoperability, and cybersecurity are common across states. Almost every state includes behavioral health access and substance use disorder treatment as a priority. Across states, RHTP proposals emphasize strengthening the rural care infrastructure, building local partnerships, and addressing long-standing gaps in access.
NRHA anticipates updating this document as additional applications and award decisions are released. Additionally, we created an interactive map tool to also assist in navigating the guide based on your state. For more information, please see NRHA’s Rural Health Transformation Program webpage.
If you have any additional questions on this guide, please reach out to NRHA’s Chief Policy Officer, Carrie Cochran McClain (ccochran@ruralhealth.us).