All 50 states have applied to participate in the $50 billion Rural Health Transformation Program, according to an announcement from the Centers for Medicare & Medicaid Services (CMS). The program was established under the Working Families Tax Cuts legislation [Public Law 119-21] and aims to improve health care in rural areas across the United States.
States were invited to submit proposals between September 15 and November 5, 2025. Each application needed to outline plans for expanding access, enhancing quality, and improving patient outcomes through sustainable, state-led 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 designed as a major investment in strengthening rural health infrastructure and building lasting systems of care. Its five strategic goals are supporting rural health innovations and preventive care; ensuring sustainable access by improving provider efficiency; developing a strong workforce; testing new models of care delivery; and expanding technology use in rural settings.
Applications will first be reviewed by CMS for completeness and compliance with program requirements as detailed in the Notice of Funding Opportunity. States with approved applications will receive baseline funding equal to half of total available funds, distributed equally among them.
A second merit review phase will evaluate how well each proposal aligns with program goals using data-driven assessments conducted by federal and non-federal experts under federal oversight. This process determines allocation of the remaining funds.
CMS expects to announce awardees by December 31, 2025. Funding will be distributed over five years starting in fiscal year 2026. As implementation begins, CMS’s Office of Rural Health Transformation will provide technical assistance and ongoing support for participating states.
“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.”
Further details about the Rural Health Transformation Program are available at https://www.cms.gov/priorities/rural-health-transformation-rht-program/rural-health-transformation-rht-program
