Rural Health Transformation Program

Rhode Island’s rural communities face unique challenges, including limited access to care, workforce shortages, transportation barriers, and persistent health disparities.

The RHTP provides a historic opportunity to transform Rhode Island’s rural healthcare landscape. By aligning local innovation with federal priorities, we can:

• Expand access to care close to home
• Strengthen financial stability for rural services
• Build integrated, coordinated care systems
• Invest in a workforce prepared to meet community needs
• Support innovative models of care
• Improve rural health outcomes and chronic disease management

While Rhode Island is the smallest state, rural health disparities affect thousands of residents.

Federally Designated Rural Area: New Shoreham (Block Island)

Rhode Island-Specific Rural Definition:

• Developed by the Office of Primary Care and Rural Health and approved by the Federal Office of Rural Health Policy to guide administration of the State Offices of Rural Health Program.
• Identifies 18 Rhode Island towns as having rural health challenges, including:
  • Limited access to providers
  • Transportation barriers
  • Higher rates of chronic disease
  • Reduced access to behavioral health and specialty care
• View Rhode Island’s current rural health definition.

• Total Funding: $50 billion nationally over five years (~$10 billion annually).
• Base Allocation: If all states apply, Rhode Island could receive ~$100 million per year for five years.
• Discretionary Funds: Additional funds may be awarded based on rurality and other factors.
• Administration: No state match required. No more than 10% of funds may be used for state administrative expenses. Funds must be used by the end of the fiscal year following the year in which they were allotted.
• Timeline:
  • CMS expected to release Notice of Funding Opportunity: Mid-September 2025
  • Application due: Fall 2025 (expected early November)
  • Awards announced: December 31, 2025
  • Program begins: Quarter 1 of 2026

As part of the application, the State of Rhode Island will develop a Rural Health Transformation Plan to secure funding and guide investments that improve care delivery in rural communities. 

Rhode Island’s Rural Health Transformation Plan must describe how the state will:

1. Improve access to hospitals and other providers for rural residents;
2. Improve healthcare outcomes of rural residents;
3. Prioritize use of new and emerging technologies that emphasize prevention and chronic disease management;
4. Initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other providers to promote quality improvement, increase financial stability, maximize economies of scale, and share best practices;
5. Recruit and retain clinicians;
6. Prioritize data- and technology-driven solutions that help rural providers furnish healthcare services as close to the patient’s home as possible;
7. Outline strategies to manage long-term financial solvency and operating models of rural hospitals; and
8. Identify specific causes that are driving standalone rural hospitals to close, convert, or reduce service lines.

As part of the State’s application to CMS, Rhode Island must commit to selecting at least three of the following allowable activities under the RHTP statute: 

1. Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.
2. Providing payments to healthcare professionals for the provision of healthcare items or services, as specified by the CMS Administrator.
3. Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
4. 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.
5. Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
6. Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
7. Assisting rural communities to right size their healthcare delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
8. Supporting access to opioid use disorder treatment services, other substance use disorder treatment services, and mental health services.
9. Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
10. Additional uses designed to promote sustainable access to high-quality rural healthcare services, as determined by the CMS Administrator.