Rural Health Transformation Program (RHTP): What It Is, How Much Funding Is Available, and Where Technology Fits In
The Rural Health Transformation Program (RHTP) is a $50 billion federal initiative administered by the Centers for Medicare & Medicaid Services (CMS) that gives all 50 states flexible grants, $10 billion a year from fiscal year 2026 through 2030, to modernize rural healthcare access, workforce, and technology. Rather than funding hospitals or health systems directly, CMS distributes the money to states, which design their own transformation plans around their rural population's specific needs.
Below is what the program covers, how the money is being distributed, which states are already putting it to work, and how technologies like Remote Patient Monitoring (RPM) fit into the picture.
What Is the Rural Health Transformation Program?
RHTP was authorized under the One Big Beautiful Bill Act (Public Law 119-21) and is overseen by CMS's Office of Rural Health Transformation. It's designed to strengthen rural healthcare delivery for the more than 60 million Americans who live in rural communities, places where patients often travel farther for care, chronic disease rates run higher, and workforce shortages are more acute than in urban settings.
Instead of a one-size-fits-all federal program, RHTP hands states the flexibility to invest in whatever mix of solutions best fits their own rural providers and patients.
How Much Funding Is Available, and How Is It Distributed?
All 50 states applied and all 50 were approved. Here's how the money breaks down:
- Total program size: $50 billion over five years (FY2026–FY2030), or $10 billion annually.
- Distribution formula: Half of each year's $10 billion is split evenly across all approved states, $100 million per state, per year. The other half is allocated by CMS based on rural population, number of rural facilities, state policy actions, and the strength of a state's proposed initiatives.
- First-year (2026) awards: States received first-year awards averaging $200 million, ranging from $147 million (New Jersey) to $281 million (Texas). Texas, Alaska, and California received the largest first-year totals.
- Deadline pressure: First-year funds must be fully spent by September 30, 2026, a tight runway that's already pushing states to move quickly from planning into procurement.
Only the 50 states are eligible; Washington, D.C. and U.S. territories are not.
What Are RHTP's Five Strategic Priorities?
Every state's plan looks different, but CMS built the program around five priorities:
| Priority | What It Covers |
| Make Rural America Healthy Again | Prevention, wellness programs, and chronic disease management |
| Sustainable Access | Strengthening the long-term financial and operational viability of rural providers |
| Workforce Development | Recruiting, retaining, and supporting rural healthcare professionals |
| Innovative Care | New care delivery models that improve quality, coordination, and efficiency |
| Technology Innovation | Digital health infrastructure, AI, cybersecurity, and technology-enabled care |
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Where Is RHTP Money Actually Going Right Now?
As of mid-2026, implementation is well underway and states are taking noticeably different approaches:
- Texas ("Rural Texas Strong") is funding six initiatives that explicitly include establishing care systems for active remote monitoring for patients with more serious or complex health issues, direct match for RPM.
- Missouri is using a hub model, organizing three-to-five county regions that connect hospitals, clinics, pharmacies, EMS, and community organizations under a single coordinating structure.
- Arkansas, Connecticut, Louisiana, and Tennessee have all identified technology-driven access expansion as a core focus of their state plans.
- North Carolina has already selected the organizations that will lead its hub-based implementation.
- New Jersey has released a formal Request for Applications aimed at advancing technology, prevention, and workforce capacity.
How Does Remote Patient Monitoring (RPM) Fit Into RHTP?
Remote Patient Monitoring uses connected medical devices, like blood pressure monitors, glucose meters, weight scales, digital thermometers and pulse oximeters, to let providers track a patient's chronic condition data between office visits. For rural patients facing long drives to the nearest clinic, RPM extends a provider's visibility beyond the walls of the practice and supports earlier intervention.
RPM lines up directly with at least three of RHTP's five priorities. It supports chronic disease management (Make Rural American Healthy Again), it's a technology-enabled care model (Technology Innovation), and it's already named as an eligible use of funds in at least one approved state plan (Texas). As more states finalize procurement for their technology initiatives throughout 2026, RPM is positioned as one of the more "shovel-ready" investments available under the program.
Why Was RHTP Created?
RHTP was created alongside broader federal Medicaid policy changes in the same 2025 reconciliation law, and lawmakers have described it in part as a way to help offset the impact of those changes on rural providers. CMS has said the funding is intended to benefit rural communities more broadly, not just to backstop hospital finances, which is reflected in the breadth of eligible uses, from workforce grants to nutrition programs to digital infrastructure.
Frequently Asked Questions
What is the Rural Health Transformation Program? A $50 billion CMS program that gives all 50 states flexible, five-year grants (FY2026–2030) to improve rural healthcare access, workforce, and technology.
How much RHTP funding did each state get? First-year (2026) awards averaged $200 million per state, ranging from $147 million in New Jersey to $281 million in Texas. Half of all funding is split equally among states; the other half is allocated based on rural need and plan strength.
When do states have to spend their RHTP funds? First-year funds must be fully spent by September 30, 2026. Subsequent years follow their own annual spend-down deadlines through FY2030.
Does RHTP fund remote patient monitoring? Yes. RPM falls under the program's "Technology Innovation" and "Innovative Care" priorities, and at least one state (Texas) has explicitly named active remote monitoring as a funded initiative in its approved plan.
Which states are furthest along in using RHTP funds for technology? Arkansas, Connecticut, Louisiana, Tennessee, Texas, Missouri, and North Carolina are among the states that have publicly detailed technology-focused initiatives as of mid-2026.
Looking Ahead
RHTP is one of the largest federal investments in rural healthcare in recent history, and 2026 marks the shift from planning to on-the-ground implementation. As states finalize budgets and open procurement for technology initiatives, connected-care tools like RPM are likely to be among the fastest-moving categories of spend.
As rural healthcare organizations evaluate opportunities under the Rural Health Transformation Program, Remote Patient Monitoring can play an important role in supporting chronic disease management and expanding access to care. Smart Meter provides the connected devices, technology and solutions that power successful RPM programs. Learn more about the Rural Health Transformation Program and how Smart Meter supports Remote Patient Monitoring.
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About Us
Since 2016, customers have hired Smart Meter to help solve one of healthcare’s most critical challenges: remotely capturing and delivering accurate patient vitals securely and reliably every time. Today, Smart Meter is the number one trusted supplier of cellular-enabled remote patient monitoring solutions, delivering reliable, real-time patient data to healthcare providers, payers, and technology partners. With millions of vitals transmitted via its exclusive private data network for RPM built in collaboration with AT&T, Smart Meter empowers organizations to securely improve patient outcomes, reduce hospitalizations, and optimize reimbursement. For more information, visit SmartMeterRPM.com.
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Sources: CMS Office of Rural Health Transformation, HHS.gov, KFF State Health Policy Data, and state health agency announcements. Figures current as of mid-2026 and subject to change as CMS finalizes future-year allocations.
