On July 4, 2025, the H.R.1 budget reconciliation bill was signed into law. Part of this legislation included a federal $50 billion Rural Health Transformation Program (RHTP) to improve rural health care across the country.
RHTP will be administered by the Centers for Medicare & Medicaid Services (CMS). Visit CMS’s RHTP webpage for more details
The Health Care Authority (HCA), departments of Health (DOH) and Social and Health Services (DSHS) — in support of the Governor’s Office — are partnering to develop Washington state’s RHTP application.
More about the program
RHTP provides $10 billion annually for fiscal years (FYs) 2026–2030, and states have two years to spend each year’s funding. Every approved state will receive the same amount, with additional funds distributed by CMS based on a state’s rural population, rural health facilities, and other factors.
Required components and eligible activities
To receive funding, states must submit a Rural Health Transformation Plan that addresses specific, required components. States must also commit to using RHTP funds for three or more activities.
To see all the requirements, visit Grants.gov's RHTP webpage and download the full announcement in the Related Documents section.
- Required components
-
- Improve access to hospitals, other health care providers, and health care items and services provided to rural residents.
- Improve health care outcomes of rural residents.
- Prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management.
- Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other health care providers to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery.
- Enhance economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training.
- Prioritize data- and technology-driven solutions that help rural hospitals and other rural health care providers provide high-quality health care services as close to a person’s home as is possible.
- Outline strategies to manage long-term financial solvency and operating models of rural hospitals in the state.
- Identify specific causes that drive the increased rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction.
- Eligible activities
-
- Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
- Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
- Providing payments to health care providers for the provision of health care items or services.
- Providing training and technical assistance to develop and adopt technology enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
- Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of five years.
- Providing technical assistance, software, and hardware for significant information technology advances that are designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
- Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
- Supporting access to opioid use disorder treatment services, other substance use disorder treatment services, and mental health services.
- Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models.
- Designing additional activities to promote sustainable access to high-quality rural health care services, as determined by the CMS Administrator.
- Designing/implementing other programs that support sustainable access to high-quality rural health care services.
Washington state’s RHTP application
HCA, DOH, DSHS, and Governor Ferguson’s Office are working together on the RHTP application. It’s due November 5, 2025.
Governor Ferguson’s Office appointed HCA to submit the application for Washington.
-
Our key priorities for RHTP funding
-
With the public’s help, we’ve chosen the priorities in the following chart.
We’ll set aside administrative funds for reporting and evaluation, grants management, and oversight costs. Tribes will also have funds set aside.
| Priority |
Description |
Examples |
| Supporting essential hospital services |
Support ongoing and new service lines in rural hospital settings to create sustainability |
- Hospital-specific technology investments
- Networks for streamlining operations
|
| Workforce investments |
Keep, attract, and build a robust network of health care professionals in rural areas |
- Recruitment and retention
- Training
- Undergraduate and graduate medical education
- Continuing education programs
|
| Technology and building maintenance |
Expand technology’s capacity to connect patients to care, plus support for current building projects |
- Cybersecurity
- AI tools
- Telehealth tools for remote provider check-up, education, and patient care
- Minor, existing building changes or equipment upgrades
|
| Prevention and care management |
Help communities provide resources to improve health outcomes outside of medical facilities |
- Community hubs
- Discharge planning
- Health homes
- School-based care
- Chronic disease programs
- Nutrition programs
|
| Access to care |
Make health care more available by getting people to their appointments or mobile services into communities |
- Transportation
- Mobile health services
|
| Behavioral health |
Support programs focused on substance use disorders and mental health |
- Opioid treatment providers
- Mobile crisis services
- Peer supports
|
Input from people in Washington
We asked for public input to help shape our state’s strategy for implementing RHTP. We reached out through this webpage, email, and social media.
The community reached back with 285 written responses. We also had in-depth discussions with various groups interested in RHTP.
- Who we heard from
-
We received input from a wide range of groups:
- Rural hospitals and districts
- Nonprofit organizations
- Non-hospital provider groups
- Health care education programs
- State and national associations
- State agencies
- Interested individuals
- Colleges and universities
- School districts
- Tribes
- Emergency medical services and firefighters
- Public health departments
- What we heard
-
Everyone’s input helped us clarify rural health needs. Many shared their lived experiences. We found common themes throughout:
- Technology
- Hospital operations and infrastructure
- Workforce
- Service expansion and retention
- Data and EHR infrastructure
- Behavioral health
- Payment reform
- Education
- Opioid use disorder treatment
- Telehealth
- School-based care
- Special health care needs
- Wellness
- Youth-focused services
- Special health care needs
- Oral health
- Maternity and perinatal care
Resources
- Materials
-
- News and announcements
-
