FAQ: Rural Health Transformation Program (RHTP)

A $50 billion investment in the future of rural healthcare

A new U.S. federal initiative called the Rural Health Transformation Program (RHTP) will allocate $50 billion to improve rural healthcare from coast to coast over the next five years.¹ To the 20 percent of Americans living in rural areas²— whose care is often limited by provider shortages, infrastructure challenges, and having to travel long distances to receive care — the program promises to dramatically change their access to high-quality care for the better. Considering that only 11 percent of the nation’s doctors practice in rural areas³, the need is immediate.

The Rural Health Transformation Program (RHTP) represents the largest federal investment in rural healthcare infrastructure in decades. But who is eligible to receive funds, what can RHTP funds be used for, and how can medical practices and providers set themselves up to make the most of this unprecedented program? Read on to understand how RHTP is designed to elevate rural healthcare for good — and how your rural practice can benefit.

What is the Rural Health Transformation Program?

Created as part of the 2025 Federal Reconciliation Bill (also known as the One Big Beautiful Bill), the RHT Program is a $50 billion federal program whose aim is to strengthen rural healthcare through long-term investments in infrastructure, technology, and workforce development. Its goal is to improve access to care, quality of care, and patient outcomes in rural communities in all 50 U.S. states.

Unlike previous approaches, the RHTP takes a systematic view of rural healthcare challenges, recognizing that sustainable solutions require coordinated investments across multiple domains: clinical technology, operational infrastructure, and human capital development.

How will Rural Health Transformation Program funding be distributed?

The program's funding structure reflects both equity and need-based considerations. Over five fiscal years (FY2026 through FY2030), CMS will distribute $10 billion per year through a two-tiered allocation system:

Baseline Equity Distribution (50%): $5 billion per year will be divided equally among all states with approved applications, regardless of size or population. In other words, each eligible state is guaranteed to receive at least $100 million in each of the five years of the program. This ensures that even smaller states have meaningful resources to address their healthcare infrastructure needs.

Need-Based Formula Distribution (50%): The remaining $5 billion per year will be allocated using a formula that considers these factors:

• Rural population size and proportion within each state
• Number of rural health facilities requiring support
• Levels of uncompensated care, reflecting the burden of serving uninsured and underinsured populations

This split approach ensures both fairness and strategic targeting of resources where they’re needed most, the better to maximize the program’s impact in rural communities.

We’re committed to helping you navigate both the RHTP opportunity and the broader transformation of rural healthcare delivery.

How can my practice access Rural Health Transformation Program funds?

Healthcare workers should note one important aspect of the program: practices, hospitals, and providers in rural areas cannot apply directly to the Centers for Medicare and Medicaid Services (CMS) for funds. Only state governments can apply to CMS for RHTP funding; rural practices will need to work with their state’s designated lead agency to benefit from the program. Each state governor will designate a lead agency to manage the RHT Program application and distribution process.

Rural providers interested in accessing RHTP funds should take these steps:

1. Contact their state’s designated lead agency or hospital association
2. Explore opportunities to become subawardees or contractors within their state’s application
3. Connect with regional program coordinators for guidance on eligibility and application processes

What are the eligible uses and approved activities for RHT Program funds?

The T in RHTP stands for transformation, and the RHT Program has been set up to support meaningful, transformative change in the way rural healthcare is delivered. States must commit to using RHT Program funds for at least three approved activities (see the list below), and importantly, cannot use RHTP dollars to duplicate or replace existing federal funding.

According to CMS, approved uses of RHT Program funds include:

• Promoting evidence-based interventions for prevention and chronic disease management
• Providing payments to healthcare providers for specified services
• Promoting consumer-facing technology solutions for chronic disease prevention and management
• Providing training for technology adoption including remote monitoring, robotics, and AI
• Recruiting and retaining clinical workforce in rural areas (minimum 5-year commitment)
• Providing technical assistance, software, and hardware for specific IT advances
• Helping rural communities right-size their healthcare delivery systems across all service lines
• Supporting access to substance use disorder and mental health treatment services
• Developing projects that support innovative care models which include value-based care and alternative payment arrangements
• Additional uses that promote sustainable access to quality rural healthcare services, as determined by the Administrator of the program

What is the timeline for the Rural Health Transformation Program to be implemented?

Announced in September of 2025, the RHTP is moving quickly toward its first year of implementation:

• September 2025: CMS released the Notice of Funding Opportunity (NOFO)
• Early November 2025: State applications were due
• December 31, 2025: Award decisions expected
• 2026: CMS monitoring and program implementation begins

This rapid timeline means rural providers should engage with their state agencies now to ensure they’re positioned to benefit from available funding.

What kind of technology partner do practices need to succeed with the RHT Program?

The success of the RHTP will ultimately be measured not just by dollars deployed, but by sustainable improvements in care delivery, operational efficiency, and patient outcomes. This is where technology partnerships become critical.

athenahealth’s cloud-based platform is uniquely designed to help rural practices maximize their RHTP investments and build sustainable operations that don’t depend solely on physical proximity to patients. Our integrated approach combines clinical workflows, revenue cycle management, and population health tools in a single platform that grows with your practice’s needs.

Whether your state’s RHTP funding focuses on telehealth expansion, workforce development, technology infrastructure, or other areas, athenahealth’s solutions can help you implement these investments strategically — ensuring you not only meet program requirements but also build lasting operational improvements that continue delivering value long after the funding period ends. Our team understands the unique challenges rural practices face, from limited IT resources to complex payer mix dynamics, and we’re committed to helping you navigate both the RHTP opportunity and the broader transformation of rural healthcare delivery.

The opportunity for rural health providers and practices

The Rural Health Transformation Program is about much more than the money. It’s an opportunity to reimagine what’s possible for rural healthcare delivery. With strategic technology investments, workforce development, and infrastructure improvements, rural practices can build sustainable care models that serve their communities effectively while maintaining financial viability.

The next few months will be critical as states finalize their applications and begin implementation planning. Rural providers who engage proactively with their state agencies and technology partners will be best positioned to benefit from this historic investment in rural healthcare’s future.