Rural Health Transformation

 
 
 
 
 
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What you need to know

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Overview

The Rural Health Transformation Program is a once-in-a-generation opportunity to modernize rural health care and make it more sustainable. Nebraska received a preliminary notice of award from the Centers for Medicare and Medicaid Services (CMS) for approximately $218 million for the first year, which is more than what was budgeted for in the application materials. Due to the increased amount of the award, Nebraska must revise some of the application materials that were submitted. Those revised documents must be submitted to and approved by CMS before work can begin.

A project of this size and scope requires participation from many stakeholders across multiple fields. Nebraska intends to release multiple Requests for Applications (RFA) as opportunities for organizations to apply for funds and assist with implementing this important work. To learn more about Nebraska's project initiatives, view the Project Narrative.​


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Program Background

H.R.1, signed into law on July 4, 2025, enacted the Rural Health Transformation (RHT)​ Program, which allows for the allocation of funding to support the provision of health care in rural areas.​ ​​​​​

RHT Program fundi​ng consists of $50 billion dollars ($10 billion per fiscal year) to be distributed to states ​​from fiscal year 2026 through fiscal year 2030. 

$25 billion will be distributed equally amongst all approved states. The remaining $25 billion will be ​allocated by the United States Centers for Medicare and Medicaid Services (CMS) based on a variety of factors, including:

  • The state's rural population
  • The proportion of rural health facilities in the state
  • T​he situation of certain hospitals in the state
  • Other factors specified in the CMS Notice of Funding Opportunity (NOFO)​​

​​Funding Uses​

RHT Program funds must be used for three or more of the following approved uses:

  • Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
  • Providing payments to health care providers for the provision of health care items or services, as specified by the administrator.
  • Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
  • Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
  • Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
  • Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
  • Assisting rural communities to right-size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
  • Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services.
  • Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
  • Additional uses designed to promote sustainable access to high-quality rural health care services, as determined by the administrator:
    • ​Investing in existing rural health care facility buildings and infrastructure, including minor building alterations or renovations and equipment upgrades to ensure long-term overhead and upkeep costs are commensurate with patient volume, subject to restrictions in the funding policies and limitations.
    • Initiating, fostering, and strengthening local and regional strategic partnerships between rural facilities and other health care providers to promote quality improvement, improve​
  • Project Abstract​
  • Project Narrative​


Important Dates​

  • July 4, 2025: H.R.1​ was signed into law, establishing the RHT Program.
  • September 15, 2025: CMS posted the Notice of Funding Opportunity (NOFO) for the RHT Program.
  • November 5, 2025: States which choose to apply for RHT Program funding must do so by this date.
  • December 31, 2025: CMS​ must ap​​prove or deny applications by this date.

Why RHT Program Funding Matters for Nebraska

​​​With 37% of Nebraskans liv​​ing in rural areas, RHT program funding ​​has the potential to make a significant impact in our state. 88 out of Nebraska's 93 counties are rural, with 30 of these ​classified as frontier counties.  ​

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