Rural Health Transformation Program Notice of Funding Opportunity

Rural Health Transformation Program Notice of Funding Opportunity

On Sept. 15, the Centers for Medicare and Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Rural Health Transformation Program (RHTP). RHTP is a $50 billion fund spread over five years created in H.R. 1 (The One Big Beautiful Bill Act), where states can apply to receive funds to support rural health care initiatives. This is a one-time application opportunity for states, and the application period will run from Sept. 15 through Nov. 5, with awardees to be determined by Dec. 31. CMS will then determine the subsequent award amounts for the following four years of the program on an annual basis based on this initial application and continuing engagement with the states.

The Rural Health Transformation Program invites all 50 states to apply for funding to address each state’s specific rural health challenges. The Program enables states to reimagine care delivery and develop innovative, enduring, state-driven solutions to tackle the root causes of poor health outcomes specific to rural America.

The Program has five strategic goals, grounded in the statutorily approved uses of funds:

• Make rural America healthy again: Support rural health innovations and new access points to promote preventative health and address root causes of diseases.
• Sustainable access: Help rural providers become long-term access points for care by improving efficiency and sustainability.
• Workforce development: Attract and retain a highly skilled health care workforce by strengthening recruitment and retention of health care providers in rural communities.
• Innovative care: Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements.
• Tech innovation: Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients.

The $50 billion program funding will be allocated to approved states over five years, with $10 billion available each year beginning in federal fiscal year 2026. Half of the funding will be evenly distributed to all states with an approved application. The other half will be awarded to approved states based on individual state metrics and applications that reflect the greatest potential for and scale of impact on the health of rural communities.  One metric is NPs in the state having Full Practice Authority and Delaware meets this criteria.  

The deadline for states to apply is November 5, 2025. There is only one opportunity to apply for funding and one application period for this program. CMS will announce awardees by December 31, 2025, and will partner with states over the program period to ensure strong oversight and successful implementation of initiatives with lasting impact.