The Rural Health Transformation Program (RHTP) was authorized by the One Big Beautiful Bill Act (Section 71401 of Public Law 119-21) and empowers all states to strengthen rural communities by improving healthcare access, quality, and outcomes. Through innovative system-wide change, the RHTP invests in the rural healthcare delivery ecosystem.
Rural Health Transformation Program Goals
- Make rural America healthy again - Innovation and new access points to promote preventative health and address root causes of diseases.
- Sustainable access - Help rural providers become long-term access points for care by improving efficiency and sustainability.
- Workforce development - Attract and retain a high-skilled health care workforce by strengthening recruitment and retention.
- Innovative care - Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements.
- Tech innovation - Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients.
Rural Health Transformation Program Grant
The authorization for the program comes with funding totaling $50 billion for all states over five years. The funding is divided into two buckets.
- 50% or $25B distributed equally among approved states. If all states are approved, Idaho will receive $100M annually for five years, for a total $500M.
- 50% or $25B distributed on the following criteria:
- Population in rural areas
- Proportion of rural healthcare facilities in the state compared to national facilities
- Financial health of rural hospitals
- Other factors
Idaho’s Collaborative Approach
The Department of Health and Welfare (DHW) is in the process of writing Idaho’s grant application, which is due November 5. DHW solicited input from stakeholders and the public through a survey on how the grant funds should be used. The survey was actively promoted and available for about a month. More than 500 respondents from every county in the state submitted responses about how to prioritize funds. Approximately 200 of those respondents submitted concepts or ideas. Survey respondents were able to self-select if they were a member of the public or a stakeholder. Of the 503 surveys received, 216 indicated they were from the public, and 287 indicated they were rural health stakeholders.
In addition to working across divisions internally, DHW is also meeting with Idaho tribes and working with other state agencies and the Governor’s Office as it writes the application.
The top scoring use of funds by respondents:
- Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
- Assisting rural communities to right-size their healthcare delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
- Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
Idaho expects to learn how much it will receive on December 31, 2025. The funding will be sub-awarded in accordance with Idaho procurement law. More details to come.
Important Dates
- 9/5-9/30/25: Idaho conducted the Rural Health Transformation Grant application public and stakeholder input survey
- 9/15/25: Notice of funding opportunity released by Centers for Medicare & Medicaid Services
- 11/5/25: Application is due to CMS
- 12/31/25: Anticipated award decision
- 12/31/25: Earliest start date for RHTP projects