Who’s Likely to Apply — and What Rural Health Transformation Could Mean for Communities Nationwide
The Rural Health Transformation (RHT) Program is not a theoretical exercise anymore. States are already signaling their intent to apply, with several hosting public comment sessions, issuing RFIs, and drafting transformation plans.
But the real question is: What will happen if or when these states succeed?
States Most Likely to Apply
Based on early activity, public announcements, and rural demographics, the following states appear most likely to submit strong applications:
North Carolina, Pennsylvania, Ohio, Texas, Georgia – large rural populations with millions of residents who stand to benefit.
Maine, Vermont, West Virginia, Mississippi, Montana – high rural percentages, where transformation could reshape the entire healthcare system.
States already mobilizing (Maine, New Jersey, Louisiana, Minnesota, Delaware, North Carolina) – have issued RFIs, comment periods, or stakeholder calls.
These states are positioning themselves to capture funding, and their communities could see meaningful shifts in the way healthcare is delivered.
What Transformation Could Mean on the Ground
1. Communities
Greater stability for rural hospitals, reducing the fear of closures.
Expanded access to local providers, reducing the need for long travel times.
Better integration between health and social supports, particularly for older adults and families living in poverty.
2. Social Determinants of Health (SDOH)
Broadband investment fueling not just telehealth, but education and workforce participation.
Transportation initiatives improving access to care, jobs, and services.
Stronger food and housing partnerships tied to health outcomes.
3. Health Equity
Targeted support for tribal communities, migrant farmworkers, and aging populations.
Narrowing gaps in behavioral health, maternal care, and chronic disease management.
Recognition that rural is not a monolith — different communities face different equity barriers.
4. Local and Regional Economies
Rural hospitals and clinics are often among the largest local employers. Stabilizing them protects jobs and tax bases.
Workforce development pipelines create meaningful, lasting careers for caregivers, nurses, and community health workers.
Healthier communities support stronger economic participation — fewer sick days, more stable households.
5. National Impact
Lessons learned from RHT could inform future large-scale transformations in long-term care, behavioral health, and aging services.
States that succeed will provide a blueprint for federal-state partnership on complex, systemic health issues.
Rural resilience strengthens the whole health system — reducing pressure on urban hospitals and creating more balanced national capacity.
Why This Matters for Providers, Policymakers, and Innovators
For healthcare providers, this program could mean new funding streams, stronger partnerships, and relief from financial instability.
For policymakers, it’s a chance to show leadership in building resilient, equitable health systems.
For innovators and vendors, the program creates an on-ramp to pilot solutions in rural markets — from telehealth to workforce tools — with the potential to scale nationally.
The Bottom Line
The RHT Program is not just about rural America. It’s about testing whether the U.S. can design large-scale, equity-focused, sustainable solutions for communities under strain. If states rise to the occasion, the benefits will extend far beyond county lines or state borders — they will ripple across the entire healthcare system.
The opportunity is massive, the stakes are high, and the clock is ticking.
Call to Action
For rural providers and caregivers: Engage in your state’s planning sessions — your voice is critical.
For policymakers: Don’t let your state sit this out — millions in funding, jobs, and services are at stake.
For innovators: Position your solutions now — states need scalable, proven ideas to strengthen their applications.
What happens next won’t just transform rural communities — it will shape the future of health equity and economic resilience across the nation.
