Rural Health Transformation Applications Pending- Decisions Expected End of Month

PCG has been working with states to support applications to the Centers for Medicare and Medicaid Services (CMS) for the Rural Health Transformation Program (RHT Program), a $50 billion initiative established under the One Big Beautiful Bill Act (H.R. 1). Applications were due to CMS in early November 2025. CMS announced that all 50 states submitted applications, with states hoping to secure funds and begin implementation of proposed rural health reforms.  CMS has been in communication with states throughout the application review period, actively seeking clarification on key application points. PCG created a summary of all publicly available applications that outline key rural health policy initiatives, performance metrics and state-based approaches to transformative rural health care delivery. The full summary is available here: 

Rural Health Transformation Program:  Summary of State Applications 

Following the grant award, states will need to act quickly on a full range of rural health transformation implementation activities. These include program design and planning, technology enablement, workforce development and training, monitoring and evaluation, reporting, and ongoing technical assistance. PCG subject matter experts are happy to answer any questions states may have on RHT Program application requirements, as well as implementation support. As always, email us at healthpolicynews@pcgus.com.   

The full details of the RTH Program can be found in the NOFO and subsequent FAQ documents located at: https://www.cms.gov/priorities/rural-health-transformation-rht-program/overview