Transforming rural health: building stronger communities

Rural Health Transformation Program: A pathway to stronger, more resilient community health centers

Rural communities across the United States face persistent and often intensifying challenges in accessing health care. Workforce shortages, aging infrastructure, financial vulnerabilities, geographic isolation, and limited care coordination capacity all contribute to gaps in health outcomes when compared to their urban counterparts. Anyone who has worked with rural clinicians — or spent time in these communities — knows these aren’t new problems. They are long-standing realities that have been compounded year after year.

Answering the call from rural healthcare providers

Created in response to these historical disparities, the Rural Health Transformation Program (RHTP) established by Congress and the Centers for Medicare & Medicaid Services (CMS) is a welcome strategy to modernize rural care delivery, strengthen local health systems, and ensure sustainable access to high-quality primary and preventive care. It’s one of the clearest signals we’ve seen in some time that federal policy is beginning to align with what rural providers have been asking for: stability, support, and a path to long-term sustainability.

At its core, the RHTP focuses on redesigning the way rural health care is organized and financed. Backstopped by $50 billion in federal funding over the next five years, the program includes multiple components: enhancing primary care capacity, integrating behavioral health and substance-use services, accelerating the shift toward value-based payment models, strengthening digital health infrastructure, improving care coordination, and supporting workforce development. That combination — resources paired with structural reform — is exactly what rural communities have needed but rarely received.

RHTP funding and technical assistance can help CHCs integrate behavioral health, implement medication-assisted treatment for substance-use disorders, expand chronic disease programs, or bring specialty care to rural patients through telehealth.

While specific program designs may vary from state to state, the overarching goal remains the same: to transform rural health systems into more resilient, patient-centered, and fiscally sustainable networks capable of meeting community needs for generations to come.

For Community Health Centers (CHCs), the RHTP represents a significant and timely opportunity. CHCs already serve as the backbone of primary care delivery in many rural communities and are often the only access point for essential services such as behavioral health, dental care, and chronic disease management. Their mission-driven focus, community governance model, and long history of adapting to the needs of underserved populations position them uniquely well to benefit from — and contribute to — the goals of the program. Nationally, CHCs now serve more than 32 million people, many of whom live in rural or medically underserved areas.

Expanding access to care in rural communities

One of the most important opportunities for CHCs within the RHTP is the chance to expand and diversify services. Rural communities often lack comprehensive care options, forcing patients to travel long distances for specialty services or to forego care entirely. RHTP funding and technical assistance can help CHCs integrate behavioral health, implement medication-assisted treatment for substance-use disorders, expand chronic disease programs, or bring specialty care to rural patients through telehealth. By broadening their service lines, CHCs can strengthen their financial stability while providing more holistic, community-centered care.

Another major opportunity lies in the realm of payment reform. Rural health care systems, especially small clinics and hospitals, are highly vulnerable under traditional fee-for-service reimbursement. Low patient volumes, seasonal agricultural work patterns, and high rates of underinsurance can make revenue streams unpredictable. The RHTP provides support for value-based payment arrangements that reward improved health outcomes, care coordination, and reductions in unnecessary utilization. CHCs, with their strong population-health focus and history of managing care for Medicaid and uninsured patients, are natural candidates for success in value-based models. Participation can not only stabilize finances but also fund critical activities — such as care management, community outreach, and health education — that traditionally go unreimbursed.

Embracing technology to serve more patients

Digital health modernization is another pillar of the RHTP that offers clear advantages to CHCs. Rural health centers often operate with outdated technology or insufficient broadband access, which limits the expansion of telehealth, remote patient monitoring, or data-driven population management. Through the RHTP, CHCs can upgrade electronic health records, improve interoperability, invest in cybersecurity, or adopt new tools for virtual care. Enhanced digital capabilities allow CHCs to reach patients who face transportation barriers, manage chronic conditions more effectively, and participate in data exchange initiatives that support quality improvement and coordinated care.

This is where athenahealth’s role becomes real. Today, more than 20%¹ of Federally Qualified Health Centers (FQHCs) use athenaOne® to support care delivery, reporting, and the coordination needs of complex patient populations. Our network-enabled platform helps CHCs close care gaps, improve UDS reporting, and reduce administrative burden — areas where rural providers are stretched thin. Many CHCs using athenaOne have reported reductions in manual workflows, improvements in documentation quality, and stronger financial performance because their teams can redirect time toward patient care rather than paperwork. And with multiple ambient documentation partners embedded directly within athenaOne, rural clinicians can offload more of the administrative work that contributes to burnout.

The mission to support rural healthcare clinical staff

Workforce development is also a critical focus of the RHTP and a significant benefit for CHCs. Recruiting and retaining clinical staff — particularly behavioral health providers, dental professionals, and experienced primary care clinicians — remains one of the greatest challenges in rural health. Program resources may support training programs, pipeline initiatives, loan repayment incentives, and new team-based care models that empower non-traditional providers such as community health workers. These workforce supports align closely with the CHC model, which relies on multidisciplinary teams to address the social, behavioral, and physical health needs of rural populations. Improved staffing capacity enables CHCs to deliver more comprehensive, culturally competent care while reducing burnout among existing staff.

Furthermore, participation in the RHTP allows CHCs to deepen relationships with other community partners. Rural health transformation is not solely a clinical matter — it requires collaboration with public health departments, schools, social service agencies, faith-based organizations, and local governments. The program encourages and often mandates cross-sector partnerships to address social determinants of health, build community resilience, and design solutions rooted in local culture and priorities. CHCs, governed by community boards and experienced in multisector collaboration, can play a leading role in these coalitions. This leadership not only amplifies the CHC’s impact but also positions it as a central hub in the community’s health ecosystem.

What lies ahead for CHCs

Ultimately, the Rural Health Transformation Program offers Community Health Centers a pathway to strengthen their operations, expand their services, and deepen their community impact. In many rural areas, CHCs are already the most trusted and accessible health care providers. With targeted support from the RHTP, they can enhance their capacity to deliver high-quality, integrated care while building systems that are financially resilient and better aligned with the evolving needs of their patients.

By embracing the opportunities presented by the program, CHCs can help shape a future in which rural communities enjoy equitable access to health care and improved health outcomes for generations to come.

Joe Ganley is athenahealth’s vice president of government and regulatory affairs.