At the Rural Health Transformation Planning Summit on September 30, one theme echoed through every session: rural health is at a crossroads. The Summit, hosted by Health Policy Future Labs, convened federal administrators and policymakers from 43 states to hear guidance on how to create their Rural Health Transformation (RHT) Program applications to best address the challenges facing health care nationwide. 

The RHT program, administered by the Centers for Medicare & Medicaid Services (CMS), will invest $50 billion in rural health care over five years. Its goal: empower states to redesign care delivery systems for the 21st-century, emphasizing technology, workforce innovation and local context. As speakers reminded attendees, this funding opportunity will only matter if states are bold enough to rethink, not just repair, how rural care works.

Actions States Should Take: Technology & Innovation in RHT Solutions 

Throughout the summit, technology emerged as both a force multiplier and equalizer—not as a replacement—for rural providers, to extend their reach and support the capacity of existing care professionals.

• AI as a Force Multiplier: Panelists discussed how AI can relieve provider overload by scanning health data for warning signs. If a patient wears a device to track blood pressure, AI can monitor for anomalies 24/7 and flag these to a provider, rather than a provider having to manually review the data.
• Emerging Tools in Rural Care: Participants highlighted tools, including tele-ICU (eICU), tele-ultrasound, remote diagnostics and wearable devices, that bring advanced care to patients’ homes. These technologies can shift rural care from reactive to preventive, while keeping services close to home.
• Preventing Revenue Leakage: As Evan Hoffman, Director of State and Local Government Relations at Philips, emphasized,“The goal is to keep care local, where patients want to be treated. For example, many health care providers across the country are introducing virtual and mobile care solutions such as eICU, tele-ultrasound and mobile CT scan programs that enable patients to receive needed care in their own communities.” Supporting rural hospitals with telehealth and digital tools helps retain patients and revenue that might otherwise flow to urban centers. When a rural eICU can connect virtually to specialists, hospitals keep care and revenue in their communities.

Workforce & Partner Solutions for RHT 

Speakers agreed technology means little without professionals to use it. Rural states need strategies to restore the workforce, elevate local partners and build new career pipelines.

Opening the discussion, Michael Hendrix, Policy Advisor to Governor Bill Lee of Tennessee, said, “The best part of this process has been the innovators, creators and hospital administrators coming to us with ideas…seeing the RHT fund as a vehicle to drive [those ideas] for years to come.” Innovative workforce and partner solutions discussed at the summit include:

• Leveraging Pharmacies: 90% of Americans live within 5 miles of a pharmacy, which poses a key opportunity to leverage pharmacies as access points for health care. Pharmacies are underused resources for vaccines, consults and chronic care. Speakers urged states to expand clinical roles and career ladders, which can attract pharmacists to live and work in rural areas.
• Retention Through Vocation: Financial incentives like loan forgiveness can help, but long-term sustainability comes from cultivating a “pull” toward rural practice. Exposing medical students and trainees to rural rotations early, building mentorship networks and promoting digital extensions are all factors that “pull” professional to rural practices.
• Navigators and Allied Professions: The conversation highlighted community health workers, technicians and health navigators as vital connectors between systems and patients.  Expanding these roles opens career pathways for local youth, tying workforce development to community vitality. 
• Inter-State Partnerships: Health care doesn’t adhere to state borders, so collaboration across them is critical. Jack Sisson, Vice President of Policy & Strategic Planning at Heartland Whole Health Institute and former policy advisor to Governor Sarah Huckabee Sanders of Arkansas, noted “states should be the laboratories of innovation.” Sisson added, “If there was an opportunity for states to see other state proposals, and borrow some things that other states included, that would support a better use of taxpayer dollars and better overall program design.” Such cooperation could define the heartland’s competitive advantage with a multi-state ecosystem of shared learning and coordinated care at scale across state borders. 

A Long-Term Outlook Tailored to Local Needs 

Speakers stressed the need to ground innovation in local realities. Cecile Young, Executive Commissioner of the Texas Health and Human Services Commission, illustrated some of Texas’ local realities: “Texas has 254 counties and 195 of them are rural. 64 of them are frontier, which means they have fewer than 7 people per square mile,” said Young. “We have the honor of having the least populated county in the country…We can fit about 221 Rhode Islands into the state…If you’re driving from El Paso, which is in a separate time zone from the rest of the state it will take you about 12 hours to get to Texarkana.” Speakers like Young underscored the complexities of addressing rural health throughout the heartland and broader nation given the differences in rural care systems from one community to another.

Speakers additionally explained that national programs succeed when they reflect community-level contexts, urging states to paint clear pictures in their applications to show what care looks like on the ground and detail how the RHT program could change care systems. Two imperatives emerged:

• Look Beyond Medicine: Social determinants of health (SDOH)—childcare, transportation and food security—drive as much as 50% of health outcomes. States should design proposals that integrate these factors, even if that requires complementary funding streams.
• Define Measurable Metrics: Applications must include county-level benchmarks, for chronic disease, maternal health, behavioral health and pediatric care to ensure accountability and track progress.

Where to Go from Here

As the RHT program application deadline quickly approaches (November 5, 2025), states have a tremendous opportunity to be innovative and think differently about serving their state and community needs. Speakers urged states to ground proposals in local realities while building for scale, embedding cross-state partnerships, measurable outcomes and concrete workforce strategies in applications. They additionally reminded attendees that innovation should prioritize pharmacy-based care, digital tools and simplified payments systems to keep care local. Above all, states must give reviewers a clear sense of place: what rural care looks like today, in the specific state context, and how transformation could reshape it. As Hendrix reminded attendees, the RHT program gives states “permission not to accept the status quo” and move beyond patching up old systems by building the foundation for a healthier, more resilient rural care future.

This is Heartland Forward’s second Pulse piece on the Rural Health Transformation (RHT) program. Read the first piece here, Reimagining Health Care Delivery in the Heartland with the Rural Health Transformation Program, for details on requirements, timeline and opportunities across the heartland.