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Rural Health Transformation Program

The Rural Health Transformation Program is part of H.R. 1, known as the One Big Beautiful Bill Act passed by Congress and signed into law July 4, 2025. The $50 billion grant program runs from Fiscal Year (FY) 2026 through FY 2030, with $10 billion allocated per year across 50 states. The goal is to increase access to rural health providers while improving outcomes for individuals living in rural communities. 

To help inform Michigan’s strategy for prioritizing the funding from the RHT Program, MDHHS engaged with rural health providers, community partners, Medicaid beneficiaries and rural community residents.

The department sought to better understand how this one-time grant could help increase and improve sustainability for rural providers, and how rural providers can continue to thrive, expand, and serve their communities, especially with other predicted federal funding cuts being implemented.

MDHHS has integrated feedback to inform the following proposed* structure:

*We are awaiting review and approval from CMS. Funding from CMS isn’t guaranteed. Pre-planning efforts are underway in anticipation of funding.

RHT Program Proposed Structure

RHT Pre-Implementation Timeline

A pre-implementation timeline has been developed to guide this work through the coming months:

Learn More about the RHT Program

  • The RHT Program seeks to further the following Strategic Goals:

    1. Make rural America Healthy Again: Support rural health innovations and new access points to promote preventative health and address root causes of diseases. Projects will use evidence-based, outcomes-driven interventions to improve disease prevention, chronic disease management, behavioral health, and prenatal care.
    2. Sustainable access: Help rural providers become long-term access points for care by improving efficiency and sustainability. With RHT Program support, rural facilities work together—or with high-quality regional systems—to share or coordinate operations, technology, primary and specialty care, and emergency services.
    3. Workforce development: Attract and retain a high-skilled health care workforce by strengthening recruitment and retention of healthcare providers in rural communities. Help rural providers practice at the top of their license and develop a broader set of providers to serve a rural community’s needs, such as community health workers, pharmacists, and individuals trained to help patients navigate the healthcare system.
    4. Innovative care: Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements. Develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs) to reduce health care costs, improve quality of care, and shift care to lower cost settings.
    5. Tech innovation: Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, strengthen cybersecurity, and invest in emerging technologies.
  • During the pre-implementation planning period (November-December 2025), a Cross-Departmental Coordination Team will be established to:

    • Offer expert input based on each division’s area of specialization to inform program design and sustainability planning.
      Provide cross-departmental guidance to maximize impact, identify opportunities for shared investments, and prevent duplication of funding or programmatic efforts.
    • Provide guidance on language to include in Grant Funding Opportunity (GFO) and may participate on Joint Evaluation Committee to review and select grantees.
    • Review progress reports, performance data, and partner feedback to identify challenges and recommend course corrections to leadership.
    • Act as liaisons between their divisions and the RHT Program Office to support coordinated messaging, consistent reporting, and timely decision-making.
  • An RHT Advisory Council will be established to:

    • Support the development and implementation of an engagement strategy to strengthen collaboration with rural health partners, community leaders, and residents throughout the program lifecycle.
    • Provide insight and feedback to improve partner participation during implementation and evaluation, ensuring that community and stakeholder perspectives inform ongoing refinement of initiatives.
    • Offer actionable recommendations to MDHHS to inform strategic direction and policy decisions across the Rural Health Transformation initiatives.
    • Serve as a bridge between state leadership, local stakeholders, and rural communities to ensure transparent communication and shared understanding of program priorities and outcomes.

    To stay updated on the process of seating the RHT Advisory Council, including when the nomination period will open, please sign up for email updates via the RHT listserv.

  • A GFO will soon be released to support RHT efforts. Details about eligibility, timelines, and application requirements will be shared once the GFO is published.

    To receive updates as soon as the RHT GFO is released, please sign up for the listserv. Subscribers will be the first to know when the funding announcement, application materials, and technical assistance resources become available.

Michigan's RHT Application

To read Michigan's full RHT project narrative, submitted to CMS, please click the link, or the button below:

RHT Project Narrative

To review a project summary, including program goals and how Michigan plans to use the funds, please click the image below:

RHT Program Summary 

Additional Resources

Contact

Please email MDHHS-RHTP@michigan.gov with any questions.