Tracking State Releases of Rural Health Transformation Program Applications

Rebecca Lopez, Jamila McLean, and Heather Howard, State Health and Value Strategies

On November 5, 2025, the Centers for Medicare and Medicaid Services (CMS) announced that all 50 states have submitted applications for the Rural Health Transformation Program (RHTP). Created by Congress to address concerns stemming from the deep funding cuts in H.R.1, the RHTP will distribute $10 billion annually from 2026 through 2030; 50% of those payments will be distributed equally across states with an approved Rural Health Transformation Plan, while the remaining half will be distributed to states at the discretion of CMS, according to factors detailed in the funding announcement. According to the CMS press release, applications meeting baseline criteria will be subject to a rigorous, data-driven merit review for the remaining 50% of program funds, led by federal and non-federal rural health experts and overseen by senior federal review directors.

To prepare their applications, most states have solicited public input through surveys and requests for information (RFIs), hosted community listening sessions, and some have engaged consultants to support the submission process. Many have also launched dedicated websites or webpages for the RHTP to share updates and resources. State Health and Value Strategies (SHVS) has been tracking state action to prepare for the RHTP application submission and also published an expert perspective summarizing common themes emerging from states that have reported the findings of their stakeholder engagement efforts.

Both the statute and the subsequent funding announcement established tight timelines, with state applications due November 5 and CMS required by law to issue awards by the end of the calendar year.  The map below identifies states that have formally announced their submission and/or publicly released their application materials, and includes links to the publicly-available material. SHVS will continue to track state announcements regarding the RHTP and will update this map to reflect new developments.

Map updated as of: 1/8/2026