Rural Health Transformation Program

The Rural Health Transformation Program offers an opportunity for Washington state to help rural communities take important steps forward in accessible, safe, and sustainable health care.

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Washington Rural Health Transformation logo (CMS)

The Rural Health Transformation (RHT) Program is part of the H.R.1 budget reconciliation bill. The RHT Program offers $50 billion funding nationwide to improve rural health care. The Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health & Human Services (HHS) administers the program.

So far, CMS awarded Washington state about $181 million for year one of the program. These funds will support the hospitals, clinics, and providers that rural families rely on every day.

The Health Care Authority (HCA), Department of Health (DOH), and Department of Social and Health Services (DSHS)—in support of Governor Ferguson’s Office—partnered to develop and run Washington state’s RHT plan.

Latest news

Apply for the RHT Program Advisory Committee

As part of Washington state’s RHT Program, we’re organizing an advisory committee (AC). The RHT-AC will help prioritize projects, make policy recommendations, and play a driving role for the RHT Program.

If you have experience in health care or public health—or lived experience in rural Washington—as well as passion for improving systems, we encourage you to apply. Your work could make all the difference for rural Washingtonians.

Apply by Friday, April 24:

State positions for the RHT Program

We’re hiring for state positions with the RHT Program. Find these listings on GovermentJobs.com.

Stay updated on the RHT Program

Sign up for RHT Program emails.

More about the RHT program

The RHT Program 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.

CMS awarded Washington $181 million for year one of the program. States will have yearly budget reconciliation with CMS to update program plans based on allocated funds.

Washington’s plan

Read the details of Washington’s plan for the RHT Program in these key documents:

  • Project narrative: This full description of our RHT Program plan is the third and final version, accepted by CMS.
  • Revised budget: This two-pager summarizes the final budget detailed in our project narrative.
  • Governor’s endorsement: This letter from Governor Ferguson, expressing his support for our proposed plan, was part of our original application.
Initiatives

Washington’s RHT plan includes six initiatives to help build a healthier, more resilient, and financially sustainable rural health system. While the project narrative details each initiative, here’s a summary:

  • Ignite innovation in Washington’s rural hospitals: This initiative improves how rural hospitals operate. Investing in long-term solutions will give rural Washingtonians better access to high-quality specialty and emergency medical care.
  • Prevent disease and manage care in community settings: This initiative focuses on bringing health care into rural communities, beyond the walls of the doctor’s office. These community-based solutions will help rural residents access the right level of care at the right time.
  • Invest in the health of Native families: This initiative reserves a portion of RHT Program funds for sovereign Tribal Governments to make critical investments to improve the health and wellbeing of Native families.
  • Adopt technology and data solutions to enable health improvements: This initiative invests in technology that increases efficiency, access, and quality in Washington’s rural health care system. These improvements will help rural Washingtons get specialty care and monitor chronic conditions.
  • Develop Washington’s rural workforce to support rural communities: This initiative grows, trains, and maintains the health care workforce in rural Washington. With a larger and increasingly skilled workforce, rural Washington can better support individuals with long-term care needs.
  • Expand and sustain Washington’s rural behavioral health system: This initiative improves standards for behavioral health care and gets people into care faster. Mobile crisis support will decrease strain on rural hospitals and school-based behavioral health care services will better support rural youth.

Input from people in Washington

We asked for public input to help shape our state’s strategy for implementing the RHT Program. We reached out through this webpage, email, and social media. We also had in-depth discussions with various groups interested in the RHT Program.

The community reached back with over 300 written responses. We’ll continue to partner with the public as the RHT Program moves forward.

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

Disclaimer: This program is supported by CMS/HHS as a financial assistance award totaling $181,257,515.06 with 100 percent funded by CMS/HHS. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

Contact

Email: HCA Rural Health Transformation Program