CMS Rural Health Transformation Program: Missed Year 1 Funding? How to Prepare for Year 2 Opportunities

Many healthcare providers assumed the Rural Health Transformation (RHT) Program was primarily intended for rural hospitals. As Year 2 opportunities begin to emerge, however, states are expanding eligibility, refining program design, and creating new pathways for a broader range of organizations and strategic partners.

Waiting until a Notice of Funding Opportunity (NOFO) is released can leave little time to assess state priorities, establish partnerships, and align initiatives around the healthcare challenges states are trying to address.

Here’s how healthcare organizations that missed the first round of funding can prepare for new funding opportunities:

1. Understand Your State's Rural Health Priorities

Every state participating in the program submits a project narrative and implementation strategy to CMS, providing insight into the healthcare challenges, service gaps, and transformation goals it is seeking to address.

Most state programs align around Medicaid’s strategic initiatives:

• Make Rural America Healthy Again
• Sustainable Access
• Workforce Development
• Innovative Care Models
• Technology Innovation

Before pursuing funding, applicants should consider how their services and capabilities support the state's specific objectives. While one state may focus on behavioral health access, another may prioritize chronic disease management, workforce development, care coordination, oral health, or telehealth expansion.

2. Subscribe to State Funding Alerts

Many organizations miss opportunities simply because they learn about them too late.

State RHT websites often provide email subscriptions, newsletters, or funding alerts that notify stakeholders about upcoming funding rounds, program updates, and events, providing early visibility into future opportunities.

3. Attend Town Halls, Webinars, and Educational Sessions

States frequently host virtual information sessions, town halls, and educational webinars to explain program objectives and discuss future initiatives. In some cases, these events provide insight into upcoming funding opportunities before formal announcements are released.

These sessions can help applicants better understand:

• State priorities and implementation challenges
• Program expectations
• Common applicant questions
• Emerging funding categories
• Potential future initiatives

4. Review Current Awardees and Funded Projects

States are increasingly publishing information about grant recipients and funded initiatives, which can serve as valuable market intelligence.

Reviewing awardees can help organizations:

• See which types of projects are receiving support
• Identify successful program themes
• Benchmark against peers
• Discover potential collaboration opportunities

Just as importantly, award announcements often reveal where states believe investment can create the greatest impact, providing clues about future funding priorities.

5. Build Strategic Partnerships Before You Need Them

Many rural health challenges require collaboration across healthcare ecosystems. Rural hospitals, federally qualified health centers, physician practices, behavioral health organizations, dental providers, technology vendors, and regional health systems may all play a role in advancing workforce development, sustainable access, innovative care delivery, and rural health improvement initiatives.

For example, an independent healthcare provider pursuing a cancer-related initiative may find opportunities to collaborate with a regional hospital already serving as a hub for specialty care. Similarly, community organizations and provider groups may be able to combine resources and capabilities to support broader transformation goals. To help build these relationships, consider engaging with your state’s hospital association, which can be a valuable resource for identifying potential partners and facilitating connections.

6. Engage Advisors Early

Rural health funding opportunities often involve multiple stakeholders, partnership structures, compliance considerations, and long-term implementation obligations.

States are also beginning to issue Requests for Information (RFIs) as they design future programs and funding opportunities. Participating in these processes may help organizations better understand emerging priorities and contribute ideas before grant structures are finalized.

An RHT Funding Opportunity You May Be Overlooking

One of the most important lessons emerging from Year 1 is that the program should not automatically be viewed as "hospital funding." Organizations that monitor state priorities may find opportunities that closely match services they already provide.

For example, a dental organization could find opportunities tied to tele-dental services, preventive care, workforce development, or community partnerships as states work to improve rural access to dental care. The same principle applies to other healthcare stakeholders whose capabilities support state transformation goals.

We Can Help

Elliott Davis helps healthcare organizations monitor RHT developments, evaluate funding opportunities, align initiatives with state priorities, identify strategic partnerships, and navigate the application process from initial planning through implementation.

Contact Elliott Davis to start preparing for the next round of RHT funding.