Rural health care in the United States is in crisis. According to recent analysis from Chartis, 182 rural hospitals have closed or converted to models that no longer offer inpatient care since 2010, while nearly 46% of remaining rural hospitals operate with negative margins. For roughly 46 million Americans living in rural communities, this means expanding “care deserts” with less access to essential services like primary care, behavioral health, and substance use disorder treatment.
Against this backdrop arose the Rural Health Transformation (RHT) Program, created by Congress in 2025. It is a $50 billion, five-year federal investment—$10 billion annually from 2026–2030—intended to strengthen rural health infrastructure and build enduring systems of care.
Our playbook outlines how states and their health system partners can leverage funding from the RHT program to create virtual-first and EHR-integrated care models that serve as the backbone of their rural health networks and large care transformation strategies
