The State will apply for newly available funding from the federal Rural Health Transformation Program (RHTP). The RHTP was created within the federal budget reconciliation bill, H.R. 1 (Section 71401 of Public Law 119-21) which was signed into law on July 4, 2025 and makes significant cuts to Medicaid. These cuts are permanent and expected to increase the number of uninsured individuals and costs to provide health care to those individuals over the next several years, particularly in rural areas.
Nationally, these Medicaid cuts amount to nearly $1 trillion over the next 10 years. That includes an estimated $5 billion in cuts to Maine.
If awarded funding through RHTP, Maine anticipates receiving an estimated $500 million, amounting to $100 million a year over five years. States may also receive competitive discretionary funding above that amount. Funding for RHTP is temporary and one-time and must be used within the specified time period.
Public Engagement and Feedback
The State encourages public input to inform its RHTP plan and application. The State is committed to pursuing an expeditious approach that directs these time-limited funds to areas that improve the health of rural communities through innovation and collaboration.
The public, partners, and others are invited to provide feedback online at the link below through October 1, 2025.
The State of Maine will also host public information webinars about RHTP:
- Sept. 23, 2025 | Noon -- 1pm: Register here
- Sept. 24, 2025: 1 p.m. -- 2 pm: Register here
Community listening sessions will additionally be scheduled shortly to take place in October.
RHTP Structure & Funding:
Total funding for the RHTP is $50 billion nationally, to be allocated to approved States over five fiscal years, with $10 billion of funding available each fiscal year, beginning in fiscal year 2026 and ending in fiscal year 2030.
The funding will be distributed by the U.S. Centers for Medicare & Medicaid Services (CMS) as follows:
- 50% to be distributed equally amongst all States with a CMS-approved RHTP plan.
- 50% will be allocated by CMS to a subset of states based on a variety of factors including rural population, the proportion of rural health facilities in the state, the situation of certain hospitals in the state, and other factors to be specified by CMS.
Required Components:
To qualify for RHTP funding, the State of Maine will develop its RHTP plan and submit it to CMS for approval. The plan will outline how the State will address specific components required by the federal law, including how Maine’s RHTP plan will:
- Improve access to hospitals, other health care providers, and health care items and services provided to rural residents
- Improve health care outcomes of rural residents
- Prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management
- Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals, and other health care providers to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery
- Enhance economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training
- Prioritize data- and technology-driven solutions that help rural hospitals and other rural health care providers provide high-quality health care services as close to a person’s home as is possible
- Outline strategies to manage long-term financial solvency and operating models of rural hospitals in the state
- Identify specific causes that drive the increased rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction
States must also commit to using RHTP funds to support three or more of the following 10 allowable activities:
- Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
- Providing payments to health care providers for the provision of health care items or services, as specified by the CMS Administrator.
- Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
- Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
- Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of five years.
- Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
- Assisting rural communities to right-size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
- Supporting access to opioid use disorder treatment services, other substance use disorder treatment services, and mental health services.
- Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
- Additional uses designed to promote sustainable access to high-quality rural health care services, as determined by the CMS Administrator.
Additionally, CMS has identified the following strategic goals for the RHTP:
- Make rural America healthy again: Support rural health innovations and new access points to promote preventative health and address root causes of diseases. Projects will use evidence-based, outcomes-driven interventions to improve disease prevention, chronic disease management, behavioral health, and prenatal care.
- Sustainable access: Help rural providers become long-term access points for care by improving efficiency and sustainability. With RHTP support, rural facilities work together—or with high-quality regional systems—to share or coordinate operations, technology, primary and specialty care, and emergency services.
- Workforce development: Attract and retain a high-skilled health care workforce by strengthening recruitment and retention of healthcare providers in rural communities. Help rural providers practice at the top of their license and develop a broader set of providers to serve a rural community’s needs, such as community health workers, pharmacists, and individuals trained to help patients navigate the healthcare system.
- Innovative care: Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements. Develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs) to reduce health care costs, improve quality of care, and shift care to lower cost settings.
- Technology innovation: Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, strengthen cybersecurity, and invest in emerging technologies.