Key Takeaways:
- CMS approved all 50 states for Rural Health Transformation Program funding.
- Each state has its own method of determining eligible facilities and appropriate amounts to distribute.
- Funding is conditional and can be rescinded by CMS, adding accurate reporting to your administrative duties.
- Rural facilities may need to prove to their state their need for financial support.
- Facilities that recruit with career stage, specialty, and community needs in mind make more strategic staffing decisions.
Several states have rural healthcare initiatives, yet we still see workforce shortages and limited access to care.
The Rural Health Transformation Program (RHTP) is designed to support rural communities amid federal funding changes. The program encourages qualifying states to use this federal investment to grow rural workforces, improve technology, and build partnerships with nearby facilities.
What We Know About the Rural Health Transformation Program
The Rural Health Transformation Program offers rural healthcare facilities a window of support before major funding cuts are implemented.
The program provides $50 billion to the approved states, distributed over five years. Each state submitted its application by November 2025 and awaited Notices of Award through the end of the year.
The Centers of Medicare and Medicaid (CMS) control funding. They will distribute 50% of the funding to all approved states equally. Then, they will award the additional 50% to states based on rural healthcare factors like population, number of facilities, and hospital financial conditions.
Now that we know which states are approved for the Rural Health Transformation Fund, facilities can apply for a percentage of the funding.
Even after facilities secure funding, CMS can reduce, suspend, or terminate funding upon annual review if requirements are not met.
States Approved for RHTP Funding
All 50 states have been approved for the Rural Health Transformation Program funding. CMS has created the Office of Rural Health Transformation and appointed project officers to distribute funding and manage state relationships.
These officers will guide states in navigating the program’s guidelines. States that violate RHTP guidelines risk losing funding after each annual review.
As rural healthcare faces uncertainty in existing grants or other funding options, states can support these communities through RHTP.
How Will States Distribute RHTP Funding?
Today, we are still unsure which facilities will receive RHTP funding. However, some public applications can provide some insight. Let’s review the Texas RHTP application called “Rural Texas Strong: Supporting Health and Wellness.”
State leaders identified 202 rural counties that qualify for the annual $281 million award. In those counties, 155 hospitals are eligible to receive funding. The application states that each eligible county will receive “at least one award.”
The Texas Health and Human Services (HHSC) asks eligible facilities to apply for the awards in a competitive procurement process. Then, top applicants will present an oral presentation in front of a review panel. Finally, the HHSC will apply a pre-determined scoring process to determine the final winners.
From this example, we learn that:
- Not all rural healthcare facilities will receive funding.
- Some rural counties may receive more funding than others.
- Facilities that wish to receive RHTP funding may need to prepare evidence of their need and present this evidence.
Rural Health Transformation Fund Supports Locum Tenens
If the Rural Health Transformation Program provides a window of opportunity, locum tenens gives facilities more control over how they use that time. The program specifically allows funding for physician recruitment and retention, which makes flexible staffing a practical solution.
Hiring an ill-fitted provider not only frustrates rural healthcare facilities but also costs them patients. Permanent hires can take longer to hire and be difficult to fire depending on state employment laws.
With RHTP funding and locum tenens, facilities can make more strategic staffing decisions.
Locum coverage enables you to take time to find the right healthcare professionals long-term. Here are some things to consider when recruiting your next provider:
- Early-career providers often look for new opportunities within one to three years.
- Mid-career providers (10 to 15 years of experience) are often the least satisfied and the most likely to leave their job for other opportunities.
- Established providers preparing for retirement are looking for stable, purpose-driven roles.
- Previous experience in rural healthcare is a strong indicator of higher retention rates.
- Community needs should influence the specialties and roles you hire.
For example, a community struggling with mental health needs psychiatrists despite the specialty’s high turnover rates. Plan contract lengths and advanced practitioner coverage accordingly.
Consilium: Your Partner in Locum Tenens
Even when you plan ahead, healthcare is ever-changing. Over the next five years, you’ll need strong partnerships and flexible strategies.
Rural communities made up 58% of healthcare facilities that used locum tenens in 2025. Consilium Staffing helps you find exactly the right provider to maintain coverage.
With our specialty focus and regional expertise, Consilium prioritizes supporting rural communities and their healthcare needs. The more we learn about your specific needs, the better we can fill roles and offer counsel aligned with your staffing strategy.
Understand your options for long-term locum support. Call Consilium today!
