Rural Health Transformation Program

RHTP Questions Form
RHTP Feedback Form

 

The Rural Health Transformation Program (RHTP) is a $50 billion fund created by Congress to stabilize and strengthen rural health care delivery systems, including hospitals and other providers. The fund will be distributed by the Centers for Medicare and Medicaid Services (CMS) to qualifying states over the next five years. Montana's specific share depends on our application, which is due November 5, 2025.

Initiatives must address key areas like workforce, service delivery, and technology to successfully compete for these funds. DPHHS presented an overview of the RHTP and CMS priorities during a webinar on Thursday, October 2, 2025.

DPHHS is gathering input to inform Montana's application strategy.

H.R. 1, enacted on July 4, 2025, established a federal $50 billion Rural Health Transformation Program (RHTP) to stabilize and strengthen rural health care delivery systems, including hospitals and other providers.

States must apply for funding from the Centers for Medicare and Medicaid Services (CMS). It is expected that the Department of Public Health and Human Services (DPHHS) will be allocated funds to award to eligible entities in accordance with Montana’s approved rural health transformation plan.

DPHHS issued a Request for Information (RFI) for public input to help shape Montana’s RHTP application and overall strategy, and has been reviewing submissions received

Background

H.R. 1 created a $50 billion fund for states with an approved rural health transformation plan, with $10 billion available per year from FFY2026 through FFY2030. Half of the funding will be split evenly between states with an approved transformation plan, and the other half will be distributed to states at CMS’ discretion based on each state’s rural population, rural health facilities, and other CMS-defined characteristics.

To receive funding from the RHTP, states must submit a rural health transformation plan to CMS by November 5, 2025. The plan must describe how the state would use program funds to:

  • Improve access to hospitals, other health care providers, and health care items and services furnished to rural residents of the state;
  • Improve health care outcomes for rural residents;
  • Prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management;
  • Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other health care providers to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery;
  • Enhance economic opportunity for, and the supply of, health care clinicians through improved recruitment and training strategies;
  • Prioritize data- and technology-driven solutions that help rural hospitals and other rural health care providers furnish high-quality care as close to patients’ homes as possible;
  • Outline strategies to manage the long-term financial solvency and operating models of rural hospitals in the state; and
  • Identify specific factors driving the increasing rate of closures, conversions, or service reductions among stand-alone rural hospitals.

Funds must be used for three or more of the allowable activities, including:

  • Promoting evidence-based, measurable interventions to improve prevention and chronic disease management;
  • Providing payments to health care providers for furnishing health care items or services, as specified by the Administrator;
  • Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic conditions;
  • Providing training and technical assistance to support the development and adoption of technology-enabled care delivery models—such as remote monitoring, robotics, artificial intelligence, and other advanced technologies;
  • Recruiting and retaining clinical workforce talent in rural areas, with a minimum five-year service commitment to rural communities;
  • Providing technical assistance, software, and hardware to support significant information technology advancements that enhance efficiency, cybersecurity, and patient health outcomes;
  • Assisting rural communities in right-sizing their health care delivery systems by identifying appropriate service lines—including preventative, ambulatory, pre-hospital, emergency, acute inpatient, outpatient, and post-acute care services;
  • Supporting access to opioid use disorder treatment services, other substance use disorder treatments, and mental health services;
  • Developing projects that support innovative models of care, including value-based care arrangements and alternative payment models, as appropriate; and
  • Supporting additional uses that promote sustainable access to high-quality rural health care services, as determined by the Administrator.

 

CMS will award funds by December 31, 2025.

Montana has submitted its Letter of Intent to CMS to apply for the RHTP.