Rural Health Transformation Program: Opportunities for Philanthropy

The Rural Health Transformation (RHT) Program was created as part of H.R.1, a budget reconciliation bill that included significant reductions to federal health care spending. Federal Medicaid spending alone will be reduced by $911 billion over 10 years and, according to the Congressional Budget Office, lead to 10 million more people becoming uninsured by 2034.

While these cuts will have significant consequences for millions of people across the country, regardless of geography, particular concerns were raised about the harm to rural hospitals and communities. Thus, as part of the legislation, $50 billion was appropriated as a Centers for Medicare & Medicaid Services (CMS) administered grant program to provide states with funds to “strengthen rural communities across America by improving health care access, quality, and outcomes by transforming the health care delivery ecosystem” over five years.

The following issue brief is a high-level analysis of major themes as identified from initiatives and strategies in state applications, reflecting the primary foci of each state’s RHT program. Based on this analysis, we offer several recommendations for grantmaker investment and action in support of RHT initiatives and, ultimately, improving the health and well-being of rural communities. We would like to acknowledge that this issue brief would not have been possible without support from Dogwood Health Trust and the Robert Wood Johnson Foundation.