All 50 states apply for $50B Rural Health Transformation Program: 5 things to know 

Every state has submitted applications seeking a share of the $50 billion Rural Health Transformation Program, according to CMS. 

Five things to know: 

1. The program — enacted under the Working Families Tax Cuts Act and expanded through the One Big Beautiful Bill Act — aims to improve access, care quality and infrastructure in rural communities. Unlike previous federal relief programs, this one does not provide direct payments to rural hospitals. Instead, states are applying for and managing the funds. States are not legally required to allocate money to rural hospitals specifically. Some policy experts and rural hospital leaders have raised questions about whether the funding will have a substantial effect on rural providers.

2. The application period ran from Sept. 15 to Nov. 5. CMS is now reviewing all submissions to ensure completeness and compliance with the program’s funding requirements. Approved states will receive baseline funding representing 50% of the total funds, which will be distributed evenly.

3. Applications that meet the baseline criteria will then undergo a “rigorous, data-driven merit review” for the remaining 50% of the funds. The review will be led by federal nonfederal rural health experts and overseen by senior federal review directors. 

4. CMS will announce awardees by Dec. 31 and begin disbursing funds on Oct. 1. The funds will be distributed over five years. 

5. As states begin implementation, CMS’ Office of Rural Health Transformation will provide technical assistance and ongoing support to help states “design, launch, and sustain initiatives that best serve their rural communities.”

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