Rural Health Transformation Program: 5 Tips to Get Started
What is the Rural Health Transformation Program?
The Rural Health Transformation Program (RHT) is a major initiative from the Centers for Medicare & Medicaid Services (CMS). The initiative will provide states $50 billion in funding over 5 years to improve healthcare access, workforce capacity, and patient outcomes in rural communities.1
According to CMS, the program focuses on system-wide transformation of rural healthcare delivery and emphasizes measurable, outcomes-driven improvements.2
The program operates through a state-led model, with funding distributed to states that design and implement healthcare transformation strategies tailored to their populations.3 While organizations do not apply directly to CMS, they can access opportunities by aligning with state priorities, participating in state-led initiatives, and engaging with funded transformation programs.
In this article, we outline five practical tips to help organizations navigate the program and align with state-led rural healthcare transformation efforts.
How the Rural Health Transformation Program works
The CMS Rural Health Transformation Program is structured differently from many federal initiatives in that:
- CMS distributes funding to states
- States create transformation plans
- States implement programs and partnerships
This structure enables states to address unique rural healthcare challenges while aligning with national priorities.
Understanding how to engage with the program
Organizations often have questions about how the program works in practice—particularly who manages funding, how to get involved, and which partners are relevant.
In the Rural Health Transformation Program:
- States manage and distribute funding
- Organizations do not apply directly to CMS and instead participate through state-led initiatives and programs
- Opportunities are often identified through partnerships, including the healthcare system, rural and critical access hospitals, workforce organizations, educational institutions, EMS agencies, and regional collaborators
The initial application period for the program’s first-year funding has closed, with all state applications submitted in November 2025. As a result, the focus has shifted from application to implementation, with states now rolling out ongoing funding opportunities, partnerships, and initiatives as part of their transformation plans.
State implementation strategies vary widely, with many states organizing efforts around specific priorities such as workforce pipelines, maternal health, behavioral health, technology-enabled access, or regional partnership models.4
Because the program is implemented at the state level, engaging early with state stakeholders and existing partnerships is often the most effective way to understand how funding is being allocated and where your organization may fit.
With this structure in mind, a practical first step is to identify the relevant state stakeholders and initiatives in your region, and understand how those priorities are being translated into programs and partnerships. From there, you can assess where your capabilities may align.
5 tips to get started
1. Start with the program's strategic goals.
CMS defines five core priorities for the Rural Health Transformation Program:
- Improving health outcomes in rural communities
- Strengthening sustainable access to care
- Developing and retaining a high-quality workforce
- Supporting innovative care models
- Advancing technology and digital health
These priorities provide the foundation for how states evaluate initiatives, making alignment essential for any organization looking to participate.
Action step:
Review your organization’s current initiatives and map each one to at least one of these five priorities. Prioritize efforts that clearly support multiple goals.
2. Align with your state’s transformation plan.
Each state defines its own healthcare transformation plan.
Common focus areas include:5
- Expanding access to care
- Strengthening workforce development and training
- Leveraging telehealth and digital technology
- Building partnerships and integrated care initiatives
Alignment with these plans increases the likelihood that an initiative will be relevant, fundable, and integrated into broader system efforts.
Action step:
Identify your state’s transformation plan and prioritize 1–2 areas where your organization can actively participate or partner.
3. Focus on workforce development.
All 50 states have proposed utilizing Rural Health Transformation funds for workforce development initiatives.6
Workforce development is one of the most consistent priorities across the Rural Health Transformation Program.
CMS emphasizes:
- Recruitment and retention
- Training and skill development
- Expanding licensure and scope of practice7
Did you know?
Almost every rural county in the U.S. has been federally designated as a Health Professional Shortage Area (HPSA).8 This designation identifies an area, population, or facility that is experiencing a shortage of health care services.9
As a result, workforce-focused initiatives often represent one of the most practical and impactful ways organizations can contribute to rural healthcare transformation efforts.
Action step:
Identify one workforce challenge in your region, such as staffing shortages or clinical readiness gaps, and define a targeted initiative that directly addresses it.
Where simulation training fits in workforce development
Simulation-based training is one of several approaches used in workforce training and clinical readiness.
In rural healthcare—where teams may encounter complex or high-risk situations less frequently—simulation-based training provides structured opportunities to build and maintain clinical readiness without posing any risk to actual patients.
As of December 2025, several states have included simulation in their plans, including:10
- Alabama: expanding simulation-based training programs to increase the amount of simulation offered yearly
- Georgia: growing a highly-skilled healthcare workforce through a five-part strategy including simulation training
- Kansas: operating a mobile simulation lab to train clinical teams in rural communities
- Maine: investing in rural training labs and mobile simulation units
- Minnesota: building OB skills through high-fidelity simulation
- North Carolina: scaling simulation-based emergency obstetric training and emergency medical services obstetric training
- South Dakota: supporting EMS providers through simulation-based training
- Tennesse: simulation-based training and credentialing for high-acuity, low frequency events.
- Massachusetts: create a virtual workforce training platform including virtual simulations to build professional capacity
4. Engage with state-led implementation efforts.
With funding already awarded, states are now focused on implementing their transformation plans.
Organizations should:
- Engage with state agencies and program leaders as initiatives are launched
- Monitor funding opportunities, RFPs, and program updates
- Align with defined priorities as they are translated into programs and partnerships
As implementation progresses, many states are releasing funding opportunities and initiatives over time, creating ongoing entry points for participation.
Action step:
Explore the following resources to help you track and engage as opportunities develop.
- Look up (and bookmark) your state’s transformation program site.
- Use the National Rural Health Association’s State Contact Directory to identify your state contact.
- Use the National Rural Health Association’s State-By-State Funding Opportunities Map to get a visual, real-time view of where your state stands in its procurement process, from early developments through active awards.
5. Consider how you'll demonstrate measurable, outcomes-driven impact.
The program prioritizes outcomes-driven approaches, so it's important to define how impact will be measured early in the process.
CMS has advised states to consider what measurable outcomes will be used to assess the impact of each initiative. States will be required to report quarterly and annually on achievement of measurable outcomes.11
You may want to start clearly defining:
- What will improve
- How it will be measured
- How results will be reported
Action step:
Define 1–2 measurable outcomes early, along with how you will track and report them as your initiative develops.
Using simulation to measure performance across individuals and systems
In training and workforce development, approaches such as simulation can provide objective, performance-based insight into how care is delivered in practice.
This allows organizations to capture measurable data across multiple levels, including:
- Individual performance
- Team performance
- System and workflow performance
These types of insights can help organizations identify gaps, standardize practices, track improvement over time, and support broader system-level goals tied to rural healthcare transformation.
Helping you make a positive impact on rural health
Our mission at Laerdal is to help save one million more lives, every year, by 2030. We work toward our mission by partnering with healthcare organizations like yours, supporting you with simulation and healthcare education tools to improve healthcare quality in your organization.
Contact us to discuss how we can support your initiatives to improve rural health in the community you serve. Together, we can build clinical readiness, strengthen system performance, and make a positive impact on rural health.
Getting started checklist: Rural Health Transformation Program
Use this checklist to move from understanding the program to taking clear, actionable next steps.
- Align your initiatives with CMS priorities
Review your current and planned initiatives and map each one to one or more of the program’s five strategic goals. Prioritize efforts that clearly support multiple priorities. - Review your state’s transformation plan
Identify your state’s published priorities and focus areas. Select 1–2 areas where your organization can realistically contribute through partnerships or program participation. - Define a workforce-focused initiative
Identify a specific workforce challenge in your region, such as staffing shortages or clinical readiness gaps, and outline a focused initiative to address it. - Engage with state and regional stakeholders
Identify key agencies, partners, and collaboratives involved in your state’s implementation efforts. Begin tracking active initiatives, partnerships, and funding opportunities as they are released. - Establish measurable outcomes early
Define 1–2 clear, measurable outcomes. Determine how progress will be tracked and reported to align with state-level expectations for outcomes-driven initiatives.
Frequently asked questions
What is the Rural Health Transformation Program?
The Rural Health Transformation Program is a CMS initiative that provides states with $50 billion in funding over 5 years to improve healthcare access, workforce capacity, and patient outcomes in rural communities (CMS Overview).
Who can apply for Rural Health Transformation Program funding?
States apply directly to CMS. Organizations do not apply directly and instead participate through state-led programs and partnerships.
What types of initiatives are funded?
State plans commonly include initiatives focused on workforce development, expanding access to care, supporting innovation, and improving measurable outcomes.
How can organizations participate in the program?
Organizations can participate by aligning initiatives with state priorities and engaging in state-led implementation efforts, partnerships, and programs.
When does the Rural Health Transformation Program run?
The program spans fiscal year 2026 through 2030.
Who manages and distributes funding?
Funding is managed and distributed at the state level, based on each state’s approved transformation plan.
Are there still funding opportunities available?
Yes. States continue to release funding opportunities and initiatives during the implementation phase, including active solicitations and awarded programs.
How can simulation support Rural Health Transformation Program initiatives?
Simulation-based training can support workforce development and clinical readiness initiatives by providing structured opportunities for healthcare professionals to practice and maintain skills in a safe environment.
In rural settings, where high-risk or complex cases may occur less frequently, simulation can help teams build and sustain readiness without risk to patients.
It can also support measurable, outcomes-driven approaches by capturing performance data across individuals, teams, and systems, helping organizations identify gaps, track improvement over time, and align with state-level goals for measurable outcomes.
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References
- Rural Health Transformation (RHT) Program | CMS. (2025). Cms.gov. https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview
- Ibid.
- Ibid.
- Rural Health Transformation: 50 State Spotlights. (n.d.) CMS. https://www.cms.gov/files/document/rural-health-transformation-50-state-spotlights.pdf
- Ibid.
- Addressing Workforce Challenges through the Rural Health Transformation Program • Bipartisan Policy Center. (2026, May 18). Bipartisan Policy Center. https://bipartisanpolicy.org/explainer/addressing-workforce-challenges-through-the-rural-health-transformation-program/
- Ibid.
- Ibid.
- HRSA. (2023, June). What is Shortage Designation? | Bureau of Health Workforce. Bhw.hrsa.gov. https://bhw.hrsa.gov/workforce-shortage-areas/shortage-designation
- Rural Health Transformation Program State Application Summary: State-level Initiatives & Proposed Activities. (2025). National Rural Health Association. https://nrha-prod-eastus-be.azure.silvertech.net/NationalRuralHealth/media/Documents/Advocacy/2025/RHTP%20Application%20Materials%202025/RHTP-State-Tracking-Guide_Final.pdf
- Rural Health Transformation: Frequently Asked Questions. (2025). CMS. https://www.cms.gov/files/document/rural-health-transformation-frequently-asked-questions.pdf