North Carolina has been awarded $213 million by the Centers for Medicare & Medicaid Services (CMS) through the Rural Health Transformation Program (RHTP). The funding, designated for 2026, aims to improve health care access in rural areas across the state. North Carolina will also be eligible for additional annual funding over the next five years.
Governor Josh Stein said, “North Carolina has long been a leader in advancing rural health care solutions, and we are excited about how this new program can support innovations to help make rural communities healthier. Our state’s rural communities are wonderful places to live and raise a family but face unique health care challenges. This grant will connect more people to more high-quality health care.”
The North Carolina Department of Health and Human Services (NCDHHS) developed its plan after consulting with over 420 stakeholders, including hospitals, community health centers, local health departments, Tribal communities, and faith-based organizations.
“We look forward to continuing the collaborative effort needed to make sure everyone has access to affordable, high-quality, patient-centered health care while reducing the burden on rural health providers,” said NC Health and Human Services Secretary Dev Sangvai. “The North Carolina Rural Health Transformation Program is one part of our efforts to support the more than 3 million people in North Carolina who live in rural communities.”
North Carolina has one of the largest rural populations in the United States—second only to Texas—accounting for more than 5 percent of all Americans living in rural areas. The RHTP outlines six strategies for transforming rural health systems over five years: launching “NC ROOTS” hubs that link medical and social services; expanding prevention and nutrition programs; increasing mental health service access; investing in workforce development; supporting value-based care models; and enhancing technology use through artificial intelligence and broadband expansion.
Implementation will involve state agencies, community organizations, academic institutions, providers, and private partners. The state plans to create a Rural Health Innovation Fund (RHIF) to give providers better access to technology. Once federal funds arrive, NCDHHS will establish governance structures and begin building regional hubs.
Oversight will come from a statewide steering committee involving NCDHHS offices and divisions as well as universities, clinics, hospitals, schools, and local partners.
A virtual event is scheduled for January 16, 2026, where NCDHHS leaders will discuss goals for the RHTP and highlight its expected impact across North Carolina.
The program is set to improve care delivery for over 3 million residents in rural areas while supporting more than 400 facilities statewide. Over five years it is expected to bring significant federal investment into North Carolina’s healthcare system.
Despite this funding boost from CMS through RHTP grants each year until at least 2031, state officials note that recent federal legislation—specifically H.R. 1—will reduce Medicaid funding by nearly $50 billion over ten years as well as other critical hospital resources. NCDHHS plans to maximize current funds while advocating for additional support moving forward.
For further information about the Rural Health Transformation Program visit www.ncdhhs.gov/rhtp.
