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NRHA sends letter to CMS on Recommendations for future implementation of the Rural Health Transforma

NRHA sends letter to CMS on Recommendations for future implementation of the Rural Health Transformation Program: Year 1 Lessons learned

11/09/26

PRESS RELEASE

National Rural Health Association

November 9, 2026

As Year 1 awards continue to wrap up for the Center of Medicare and Medicaid Service's (CMS) Rural Health Transformation Program (RHTP), the National Rural Health Association (NRHA) writes to CMS to experiences from the rural providers, organizations, and communities working to put this investment into practice.

In year 1 of the program’s inception, CMS has awarded approximately $10 billion to states, with individual FY 2026 state awards ranging from $147 million to $281 million. In a letter sent to CMS on November 9, 2026, NRHA shares with CMS feedback from rural stakeholders on the implementation of Year 1 of RHTP.

NRHA has drawn on lessons learned by rural stakeholders to share recommendations on how to strengthen RHTP moving forward.

Lesson 1: A key driver of success is engaging expertise to shape program implementation.
Lesson 2: Obligating funds is not the same as delivering resources to rural communities.
Lesson 3: Compressed timelines and uncertainty place a disproportionate burden on small rural organizations and providers.
Lesson 4: Administrative requirements have shown to be a barrier when they are not proportionate to the size, risk, or complexity of rural settings.
Lesson 5: Rural providers should not be penalized for state level process rural projects are ready to proceed.
Lesson 6: CMS should continue transparency of RHTP implementation that supports public transparency moving forward in Year 2 and beyond.

NRHA remains strongly supportive of RHTP and its goal of strengthening rural health care through investments in workforce, infrastructure, technology, access, and sustainable models of care. A key learning from Year 1 is not that CMS should reduce the program’s ambition or its accountability. It is that the path toward transformation must be transparent, predictable, locally informed, and workable for the rural organizations responsible for delivering results.

For more information on RHTP resources, please see NRHA' RHTP Webpage.

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