New NRHA analysis shows where RHTP funds are going
PRESS RELEASE
National Rural Health Association
October 28, 2026
New data from the Centers for Medicare & Medicaid Services (CMS) provides an early look at how states are deploying funding through the Rural Health Transformation Program (RHTP), revealing wide variation in implementation pace. 1
As of July 31, 2026, states had committed (obligated) about 40%, or $4.0 billion, of the $10.0 billion of first year RHTP awards.
The National Rural Health Association reviewed CMS' data and released an released an analysis of award trends and how they have been dispersed in states.
Trends highlighted in the report include:
- Dollars are moving, but obligation rates do not tell the whole story: Obligation rates ranged from 100% to 0%, reflecting differences in state implementation strategies, procurement timelines, and award structures. States that leaned on expanding existing programs, intergovernmental agreements, or large single awards (e.g., Georgia's AHEAD contract) could obligate fast. States running competitive RFP cycles were still mid-procurement at the cutoff.
- Initial state investments focus on the building blocks of rural transformation: States are emphasizing workforce, rural hospital and health system sustainability, technology, innovative payment and service models, alongside investments in disease prevention, accessible care, population health, and health promotion. The priority now is ensuring those investments produce long term delivery system change —not simply short-term projects—for rural providers and the patients they serve.
- The next transparency challenge is following the money to the community level: States are the direct CMS awardees, but funding may pass through agencies, vendors, associations, universities, community partners, and other intermediaries before reaching rural hospitals, clinics, EMS agencies, and direct care providers. Intermediaries can play an important implementation role, but transparent, recipient-level reporting is essential to show where the money ultimately goes and who benefits.
"RHTP represents an unprecedented opportunity to strengthen rural health care, but the ultimate measure of success will be whether these investments translate into sustainable improvements in care delivery and payment models for rural communities," Alan Morgan, NRHA CEO said. "As implementation moves forward, transparency around where dollars are going - and how those investments affect rural providers and patients - will be essential."
NRHA finds future reporting should allow policymakers and rural stakeholders to assess not only how quickly states obligate awards, but also which organizations ultimately receive funding, how much reaches frontline rural providers, and whether investments produce durable improvements in rural health access and outcomes.
View NRHA's full analysis of award trends. For more information, please view CMS' report and use NRHA’s RHTP Webpage for more resources.
Your chance to speak with your reps about, and hear from the administration on, the future of rural health funding is at NRHA’s 38th Rural Health Policy Institute Feb. 9-11 in D.C.
_______________________________________________________________________
SOURCE 1. Centers for Medicare & Medicaid Services. Rural Health Transformation Program Obligated Funds. October 14, 2026; reporting period through July 31, 2026.