All 50 States Seek to Transform Rural Health with CMS

The Centers for Medicare & Medicaid Services (CMS) today announced that all 50 states submitted applications for the $50 billion Rural Health Transformation Program—a landmark initiative created under the Working Families Tax Cuts legislation [Public Law 119-21] to strengthen health care across rural America.

The application period, open from September 15 through November 5, 2025, invited every state to design a plan for transforming its rural health care system. Each proposal must outline how states intend to expand access, enhance quality, and improve outcomes for patients through sustainable, state-driven innovation.

“When every state steps up to strengthen rural health, it shows the true character of our nation,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “Rural families have been left behind—driving hours for care or going without it entirely. This program restores fairness and brings quality health care back to every American community.”

“Seeing all 50 states come forward to reimagine the future of rural health is an extraordinary moment,” said CMS Administrator Dr. Mehmet Oz. “This program moves us from a system that has too often failed rural America to one built on dignity, prevention, and sustainability. Every state with an approved application will receive funding so it can design what works best for its communities—and CMS will be there providing support every step of the way.”

The Rural Health Transformation Program is a catalytic investment designed to help states strengthen rural health infrastructure and build enduring systems of care. Guided by five strategic goals, the program aims to:

• Make rural America healthy again: Support rural health innovations and promote preventive care.
• Sustainable access: Ensure rural providers can become long-term access points for care by improving efficiency and sustainability.
• Workforce development: Build and retain a strong rural health care workforce.
• Innovative care: Test new models of care delivery to improve rural health outcomes and lower the cost of care.
• Tech innovation: Expand use of technologies that promote access and efficiency in rural settings.

All submitted applications will now undergo CMS review to ensure completeness and compliance with the requirements outlined in the Notice of Funding Opportunity. States that meet these requirements and have approved applications will receive baseline funding—representing 50% of total available program funds—distributed equally among approved states.

Applications that meet baseline criteria will then undergo a rigorous, data-driven merit review for the remaining 50% of available program funds. This in-depth review—led by federal and non-federal rural health experts and overseen by senior federal review directors—will assess each state’s proposed initiatives and alignment with program goals to ensure a fair, transparent, and consistent merit review process across all states.

CMS will announce approved awardees by December 31, 2025, with funding distributed over five years beginning in federal fiscal year 2026. As states begin implementation, program officers from CMS’s Office of Rural Health Transformation will provide technical assistance and ongoing support to help states design, launch, and sustain initiatives that best serve their rural communities.

“This is not just a funding opportunity—it’s a turning point for rural health,” Dr. Oz added. “Together, we’re delivering the largest rural health investment in American history—and building a foundation for healthier communities for generations to come.”

To learn more about the Rural Health Transformation Program, visit:
https://www.cms.gov/priorities/rural-health-transformation-rht-program/rural-health-transformation-rht-program