Conference Recap: National Rural Health Association Hosts Policy Institute
Overview of the Summit
From February 10th to 12th, more than 600 rural health providers and professionals gathered in Washington, DC for the National Rural Health Association Policy Institute. This event brought together rural health providers, state and federal elected officials and policymakers to discuss critical issues facing their communities.
Key Topics
A primary focus for attendees was the ongoing implementation of the Rural Health Transformation Program, a $50 billion initiative established in 2025 under H.R. 1. At the end of December 2025, the Center for Medicare and Medicaid Services (CMS) awarded funding to all 50 states with approved Rural Health Transformation Program (RHTP) applications. The program’s $50 billion investment will be distributed to states over five years, $10 billion per year from 2026 through 2030, to support states in redesigning and strengthening rural health care delivery systems. Participants were deeply engaged in conversations about the program’s rollout and its potential impact on rural health services.
In addition to the program’s implementation, the summit provided a forum for exploring further strategies to secure and improve access to rural health care. Attendees shared ideas and discussed what additional measures could be taken to ensure that rural communities continue to receive essential health services. Those strategies included highlighting key advocacy and pending legislation that is necessary to support the more than 62 million people in the US who rely on rural health care.
Pending Rural Health Legislation
Many members of Congress attended the policy institute meetings including Senator Ron Wyden (D-OR), Representative Jill Tokuda (D-HI), Senator Catherine Cortez Masto (D-NV), Senator Peter Welch (D-VT) as well as the Administrator of the Center for Medicare and Medicaid Services, Dr. Mehmet Oz. Each came with a perspective of rural health care in their community, and highlighted ongoing legislative and federal action to address gaps and increase access to care.
Workforce
One common theme was increasing the pool of rural providers, and incentivizing practice in rural professional shortage areas. According to HRSA, nearly 70% of rural counties are Health Professional Shortage Areas (HPSAs). Many states sought creative ways to solve workforce shortages in their applications for RHTP funds. One proven approach to closing the gaps is rural residency programs. As highlighted at the NRHA Policy Institute, “spending more than half of residency training in rural areas is associated with a 5-fold increase in rural practice.”1
Some pending federal approaches to supporting rural residency programs include:
- Rural Physician Workforce Production Act of 2025: This bill allows certain hospitals to receive additional payment under Medicare for full-time equivalent residents who receive training in rural areas.
- H.R. 1127: Rural America Health Corps Act of 2025-2026: To establish a demonstration program to provide payments on eligible loans for individuals who are eligible for the National Health Service Corps Loan Repayment Program.
Maternal Health
Another common theme was critical access to maternal health care, and creative ways to ensure timely, quality care. Many states highlighted maternal health as a RHTP application priority to address some of the realities that exist today in rural communities including that 57.4% of all US rural counties lack an obstetrician, and 75.1% lack an advanced practice midwife, with 87.4% without a midwife.2
Key legislation is currently pending at the federal level that could have the way for state level initiatives including:
- H.R.1254 – Rural Obstetrics Readiness Act (2025-2026): This bill creates and expands federal grant programs within the Health Resources and Services Administration (HRSA) to increase capacity to provide emergency obstetric health services in rural areas or areas without practitioners or facilities specializing in obstetric services.
- S. 1599: Midwives for MOMS Act of 2025 (2025-2026): A bill to address maternity care shortages and promote optimal maternity outcomes by expanding educational opportunities for midwives, and for other purposes.
As states continue to refine their approaches to RHTP implementation some key resources to assist include:
- NRHA has put together a legislative tracker by topic to health those interested in learning more about pending rural health legislation: https://www.ruralhealth.us/advocacy/rural-health-legislative-tracker.
- In December 2025, PCG published 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: PCG-RHTP-State-Submission-Summary.pdf.
If you have any questions about your state approach to implementation of RHTPs, PCG has experienced subject matter experts who can help support. Email us at healthpolicynews@pcgus.com or book time directly here: click to book.
PCG was a proud sponsor of the 2026 National Rural Health Association Policy Institute.
