Copyright Newsweek
Three states have announced their submissions of their Rural Health Transformation (RHT) plans to the Centers for Medicare & Medicaid Services (CMS) this week. On Wednesday, the deadline for submission, North Dakota Governor Kelly Armstrong and Missouri Governor Mike Kehoe both announced that their plans have been submitted. Mississippi Governor Tate Reeves unveiled his state’s plan Tuesday. Many of the initiatives outlined in these plans focus on building infrastructures to improve telehealth access and strengthen the health care workforce in rural communities. Why It Matters In September, CMS announced the Rural Health Transformation Program, which was authorized by the One Big Beautiful Bill and aims to improve health care access, quality and outcomes by transforming the healthcare delivery system in rural communities across America. The program allocates $50 billion to approved states over five years, starting in 2026. Half of the funding will be distributed equally to all approved states and the other half will be allocated by CMS based on factors like rural population and the proportion of rural health facilities in the state. During Sanford Health's Summit on the Future of Rural Health Care in Sioux Falls in October, CMS Administrator Dr. Mehmet Oz said he doesn't want to U.S. to be "one big health care system with a small country attached." “The best practices that we discover to help scale health care more effectively in rural America will also work in urban America, suburban America, other counties," he said during his address. "So let's use this grand experiment, this five-year effort, to transform health care, to start with rural health care, but spread the wisdom.” This comes as rural communities are struggling with health access amid Medicaid cuts, hospital closures, labor shortages and lack of access to digital care. What To Know In Missouri, Kehoe said his plan will create a unified, regional network to connect providers, pharmacies, public health agencies and at-home resources; expand access to primary care, behavioral health and maternity services; strengthen specialty and complex care through telehealth and patient-focused technology; increase collaboration between local partners to advance technology, operations and care delivery; and incentivize better health outcomes through shared savings of avoidable health care costs. “We appreciate the Trump Administration's focus on strengthening rural communities and creating this historic funding opportunity through the One Big Beautiful Bill,” he said in a statement. “Missouri's Rural Health Transformation plan is a collaborative effort that will be embedded into every facet of our healthcare system, creating a lasting impact for future generations of rural Missourians.” Mississippi's Reeves said his plan was developed with broad input from key stakeholders across the state and is focused on “improving health care and patient outcomes for Mississippians, strengthening the state’s rural health workforce and ensuring sustainable access to care for those who need it most.” The goal, he said, is to ensure every person in rural Mississippi has reliable access to high-quality health care services, including through telehealth, to improve access and health across the state by 2031. “The Rural Health Transformation Program is a once-in-a-generation opportunity to make a lasting impact on the health of our rural communities,” Reeves said in a statement. “While Mississippi has long faced challenges in delivering access to quality healthcare in rural areas, our plan is designed to address those challenges head-on. We are ready to implement our plan with accountability, transparency and results-driven oversight.” Armstrong said North Dakota’s plan centers around four main initiatives. These include strengthening and stabilizing rural health workforce, making North Dakota healthy again with preventive care and healthy eating, bringing high-quality health care closer to home and connecting technology, data and providers for a stronger North Dakota. Developing a telehealth infrastructure and building a modern statewide health care data hub are key components to the plan. Each initiative includes activities like creating a new workforce pipeline through expanded residencies and training programs and the launch of North Dakota Moves Together to encourage physical activity and community connection. “North Dakota is a proud rural state. Whether you live in Beach or Belcourt, Crosby or Colfax, or anywhere in between, North Dakotans should have access to high-quality health care," Armstrong said in a statement. “The Rural Health Transformation Program gives us an opportunity to think about ways to bring sustainable and transformational care to our rural communities. We appreciate President Trump, CMS Administrator Oz and our congressional delegation for supporting this funding that will be transformational for health care delivery in North Dakota.” What Happens Next The deadline to submit an application was November 5, 2025. CMS will review each proposal and notify awardees by December 31, 2025. The funding will then be distributed in the form of a cooperative agreement over the next five years. Monitoring and support from CMS will begin next year. What People Are Saying Jess Bax, the director of the Missouri Department of Social Services (DSS), said in a statement: “Our department was proud to collaborate across state agencies and with key stakeholders to craft this bold plan. We look forward to continuing our work to support Missourians with this historic funding opportunity that will change the landscape of healthcare access and outcomes for rural Missourians.” Mississippi Governor Tate Reeves said in a statement: “I’d like to thank President Trump, Secretary Kennedy, and Administrator Oz for the opportunity to submit this plan. We are excited to make meaningful and lasting change in the delivery of healthcare throughout Mississippi. I know that together, our plan will make a positive impact on the lives of Mississippians in rural communities across our state.” Pat Traynor, interim commissioner of North Dakota Health and Human Services (HHS), said in a statement: “This is a once-in-a-lifetime opportunity to strengthen rural health care delivery in North Dakota. Our plan prioritizes better access to care and long-term wellness while advancing our vision to make North Dakota the healthiest state in the nation.” Newsweek reached out to the offices of the Mississippi, Missouri and North Dakota governors for comment.
