Why Rural Health Transformation Matters Now

Rural communities are the backbone of America, yet they face some of the most profound health challenges—hospital closures, workforce shortages, lengthy travel times for emergency care, and limited access to behavioral health services. The new CMS Rural Health Transformation (RHT) Program offers an unprecedented opportunity: $50 billion over the next decade to help states reimagine how care is delivered in rural areas.

This is the most significant federal rural health investment in decades—and it comes with high expectations for states to act quickly, strategically, and inclusively.

About the RHT Program

The RHT Program is a state-only cooperative agreement administered by CMS. Every state has the chance to apply, but they must do so with a Governor’s endorsement and a designated Authorized Organizational Representative. Once approved, states can make sub-awards to local partners, including rural hospitals, clinics, EMS providers, Tribal health organizations, universities, and even urban hospitals—when the outcomes benefit rural communities.

Funding is distributed in two parts:

• Baseline Allocation: Every approved state receives an equal share.
• Workload/Technical Allocation: Additional funding is based on rural population factors and the strength of each state’s application. Importantly, CMS re-scores technical performance annually, meaning strong governance, reporting, and measurable outcomes are essential.

What Funds Can Support

States can choose from a menu of approved uses that align with urgent rural needs, including:

• Expanding access to primary care, emergency care, and behavioral health
• Recruiting and retaining a clinical workforce (with service commitments in rural areas)
• Investing in tech-enabled solutions—telehealth, remote monitoring, AI, cybersecurity
• Supporting opioid use disorder and substance use disorder treatment.
• Testing innovative models of care like hospital-at-home or value-based arrangements
• Modernizing IT systems—interoperability, HIE participation, and data-sharing

Each funded initiative must identify at least four quantifiable outcomes, with one measured at the county or community level. These can include reduced emergency department wait times, improved maternal health indicators, increased rural primary care visits, or expanded adoption of telehealth.

What It Means for States and Partners

For states, the challenge is both strategic and operational:

• They must inventory rural assets (hospitals, clinics, EMS, community health providers) and make defensible decisions about where to invest.
• They must create implementation plans with timelines, governance structures, and sustainability strategies to ensure benefits last beyond the grant period.
• They must show structured stakeholder engagement—from Tribal liaisons and rural health offices to provider associations and community organizations.

For local partners—rural hospitals, EMS agencies, and Tribal providers—this program presents an opportunity to shape new delivery models, secure sustainable funding, and connect with broader statewide reforms. However, the path runs through the state application, making early engagement critical.

Where Briljent Fits

At Briljent, we view our role as a bridge between federal requirements and successful state implementation. We help states and their partners:

• Fund: Identify funding opportunities, shape APDs (Advanced Planning Documents), and align financial strategies with CMS rules.
• Plan: Facilitate stakeholder engagement, governance structures, and readiness assessments.
• Implement: Deliver training, organizational change management, IT modernization, and interoperability solutions.
• Sustain: Build evaluation frameworks, compliance monitoring, and outcome reporting that satisfy CMS’s annual scoring.

We’ve supported states in Medicaid IT modernization, organizational change management, and training integration—the exact domains CMS is funding under RHT. That means we’re ready to help states design strong applications now and deliver measurable results over the program’s ten-year horizon.

Call to Action

The RHT Program is a once-in-a-generation opportunity to transform rural health care. States that succeed will not only draw down billions in federal funding but also leave a legacy of stronger, more sustainable systems of care for rural residents.

If you’re a state leader, provider, or partner exploring how to participate, Briljent can help you navigate the process, engage stakeholders, and build programs that endure.

👉 Let’s partner for impact. Contact us to learn how we can support your RHT strategy and application.