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Rural Health Transformation Program

What is the Rural Health Transformation Program?

On July 4, 2025, P.L. 119-21, the One Big Beautiful Bill Act (OBBBA), was signed into law. Among several provisions, it created the Rural Health Transformation Program (RHTP), a $50 billion fund for rural healthcare providers. All 50 states are eligible to apply for this funding. 

To qualify, states will need to apply to the Centers for Medicare and Medicaid Services (CMS) for approval. CMS is required to approve or deny applications by December 31, 2025. 

Funding will be distributed in $10 billion annual allotments from Fiscal Years (FYs) 2026 to 2030: 

  • 50% of the funding will be allocated equally across all states that have approved applications; and  

  • 50% will be distributed at the CMS Administrator’s discretion to “not less than one-fourth of the states with an approved application.”

States can apply to use the funds in a variety of ways, such as for promoting care interventions, paying for health care services, expanding the rural health workforce, and providing technical assistance with system transformation.

Feedback Form for the Rural Health Transformation Program (RHTP)

The Illinois Department of Healthcare and Family Services (HFS) welcomes feedback and comments on how Rural Health Transformation Program (RHTP) funds can be used to support rural health communities as outlined in P.L. 119-21. The feedback and comments received will be considered for incorporation into the State of Illinois’s forthcoming RHTP application.  

All written comments must be received by 11:59 PM on Friday, September 12, 2025. 

What should I provide feedback on?

Section 71401 (2)(A)(i) of P.L. 119-21 states that an application must include a detailed rural health transformation plan. What thoughts, reactions, or information can you provide on the following points?

  • Improving access to hospitals, other health care providers, and health care items and services furnished to rural residents of the State;

  • Improving health care outcomes of rural residents of the State;

  • Prioritizing the use of new and emerging technologies that emphasize prevention and chronic disease management;

  • Initiating, fostering, and strengthening local and regional strategic partnerships between rural hospitals and other health care providers in order to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery; 

  • Enhancing economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training;

  • Prioritizing data and technology driven solutions that help rural hospitals and other rural health care providers furnish high-quality health care services as close to a patient’s home as is possible;

  • Outlining strategies to manage long-term financial solvency and operating models of rural hospitals in the State; and

  • Identifying specific causes driving the accelerating rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction. 

Further, section 71401 (6) of P.L. 119-21 states that funding shall be used for at-least three or more health-related activities. What are your suggestions, thoughts, and recommendations for prioritizing the following health-related activities?

  • Evidence-based, measurable interventions to improve prevention and chronic disease management.

  • Consumer-facing, technology-driven solutions for the prevention and management of chronic disease.

  • Training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals.

  • Recruiting and retaining clinical workforce to rural areas. 

  • Technical assistance, software, and hardware for information technology advances to improve efficiency, enhance cybersecurity, and improve patient outcomes.

  • Rural communities in right sizing their health care delivery services by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines. 

  • Opioid use disorder treatment services and other substance use disorder treatment services and mental health services.

  • Innovative models of care that include value-based care arrangements and alternative payment models. 

  • Additional uses that promote sustainable access to high quality rural health care services.

When providing feedback, please note:

  • Feedback submitted for this listening session will not be used to fund specific, individual projects or providers.

  • This session is not a forum for HFS to receive individual complaints about specific healthcare providers or service plans. It is also not the proper forum for HFS to receive information from a vendor about its supplies, services, and operating models.

  • Regardless of how feedback is provided, note that it later may be shared outside of HFS pursuant to HFS’s obligations under FOIA. Therefore, comments should not include personal health information or other details commenters wish to remain private.