Assessing Your Rural Health Landscape: Data Every State Needs
The Rural Health Transformation (RHT) Program is a competitive funding opportunity — states that make the strongest, most data-driven cases for need, readiness, and impact will secure their share of $50 billion in federal investment.
A persuasive application begins with a clear, credible assessment of the state’s rural health landscape. That means knowing the numbers, understanding the gaps, and connecting data to human impact.
This second installment of the RHT Application Roadmap series focuses on exactly how to do that.
Step 1: Define Rural — and Be Consistent
Start by clarifying how your state defines “rural.” CMS will use the U.S. Census Bureau’s urban–rural classifications unless a state provides a strong rationale for another method (such as Health Resources and Services Administration rural health service areas).
Tip: Use a single, consistent definition throughout the application — it keeps your data coherent and credible.
Step 2: Gather Core Rural Demographic Data
Every state application should include a baseline demographic profile of its rural population. Think of it as a snapshot of who rural residents are and where they live.
Include:
Total rural population (absolute count)
Percent of total population that is rural
Geographic distribution (by county or region)
Population trends (growth, decline, or aging)
Example:
Texas: 4.7 million rural residents (~16% of total)
Maine: 840,000 rural residents (~62% of total)
California: 1.9 million rural residents (~5% of total)
This dual lens — absolute count and share — helps CMS understand both scale and intensity of rural need.
Step 3: Map Key Health Indicators
The goal is to show where transformation is most needed and what it will fix. Identify and visualize:
Hospital and clinic closures over the last 10 years
Provider shortages (primary care, behavioral health, long-term services)
Chronic disease prevalence (e.g., diabetes, COPD, cardiovascular disease)
Behavioral health and substance use indicators
Mortality and preventable hospitalization rates
Where to get data:
CMS Hospital Compare
HRSA Area Health Resource Files
CDC PLACES data
State health department dashboards.
Combine maps and short narrative summaries — CMS reviewers respond well to visuals that show trends over time.
Step 4: Assess the Workforce Landscape
Rural transformation hinges on a strong workforce. Capture:
Current supply of clinicians, nurses, direct care workers, and community health aides
Training pipelines (community colleges, nursing schools, caregiver programs)
Vacancy and turnover rates
Average travel time for residents to reach care
Highlight innovative workforce initiatives already in motion — apprenticeships, tele-supervision models, or retention incentive programs. CMS values evidence that the state can scale success.
Step 5: Integrate Equity and Access Data
Equity is central to rural health transformation. Include data on:
Tribal and Indigenous health outcomes
Migrant and agricultural worker populations
Broadband access and digital literacy gaps
Transportation and housing instability
Pair quantitative data with short case examples that humanize inequities. For instance: a county with high hospitalization rates and no broadband access, or a tribal community traveling hours for basic services.
Step 6: Create a Baseline Scorecard
To make your assessment actionable, convert data into a baseline scorecard. Use a simple 3- to 5-point scale across categories such as:
Hospital and provider stability
Workforce sufficiency
Broadband and technology readiness
Population health outcomes
Health equity performance
A scorecard makes it easy for CMS reviewers to grasp where your state stands today — and where transformation funding can drive measurable progress.
Step 7: Tell the Story Behind the Numbers
Data earns attention, but stories earn approval. Connect the numbers to lived experiences: rural hospitals closing mid-pandemic, caregivers traveling 100 miles between clients, families losing behavioral health access after a provider retires.
The best applications balance analytics and empathy.
The Bottom Line
An effective RHT application begins with a clear-eyed view of the state’s rural health ecosystem — who’s there, what’s working, and what’s failing.
By building a transparent, data-rich baseline assessment, states don’t just meet CMS’s requirements — they establish a roadmap for tracking real transformation over time.
Call to Action
State health officials: Start compiling demographic, workforce, and equity data now — don’t wait for CMS to ask.
Providers and advocates: Share your data and on-the-ground realities with your state’s RHT team.
Technology and analytics partners: Offer visualization and dashboard tools that can turn raw data into compelling evidence.
The foundation of every successful RHT plan is data — but its heart is the community it serves. Build both into your landscape assessment, and you’ll set the stage for a winning application.
