Rural Health Transformation Program (RHTP)

Background

The Rural Health Transformation Program (RHTP) was authorized by H.R. 1 (Section 71401 of Public Law 119-21) and through a $50 billion fund empowers states to strengthen rural communities across America by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem. Through innovative system-wide change, the RHTP invests in the rural healthcare delivery ecosystem for future generations.
In December 2025, the State of Maryland was awarded $168 million in federal funding to strengthen and modernize health care in the 18 state-designated rural areas across the state. The RHTP funding, which is renewable over five years, will serve to enhance the state’s ongoing efforts to bolster health care access and affordability in Maryland’s rural communities:

Here is a map of the Rural Maryland: State-Designated Counties.

Find more information about the RHTP proposal process here.

Maryland RHTP Plan and Implementation

The Maryland RHTP is facilitated by the Maryland Department of Health's State Office of Rural Health (SORH). The CMS-approved Maryland RHTP focuses on three areas of impact (1) Transform the Rural Health Workforce, (2) Promote Sustainable Access and Innovative Care for Rural Marylanders, and (3) Empower Rural Marylanders to Eat for Health. Each focus area highlights opportunities for: near-term Immediate Impact Funds and longer-term Transformation Funds, as described below for Budget Period 1.

Maryland’s Rural Health Transformation Program supports the Maryland Rural Health Strategic Plan, 2025-2030.

PILLAR 1: Transform the Rural Health Workforce

Expand existing and implement new efforts to develop, recruit and retain a strong health workforce in rural communities, addressing multiple types of health care clinicians and allied health professionals.

Immediate Impact Funds

Pathways to Health Careers: Expand existing Apprenticeship and Training Programs and expand the Rural Advancement for Maryland Peers (RAMP) allied health program. (MD Labor)

Area Health Education Centers (AHEC): Expand the capacity of existing AHEC programs and open a new AHEC in Southern Maryland. (UMD/ AHEC)

Health Workforce Clearinghouse: Implement a Maryland Health Workforce Data Clearinghouse. (MDH/ OPHI)

Workforce Data System: Create an online platform for healthcare workforce development applications. (MDH/ OPHI)

Transformation Funds

Workforce Pipeline Training Programs: Increase recruitment and training opportunities for healthcare and public health professionals. (MD Labor)

Provider Training, Recruitment and Retention Strategies: Expand training, recruitment and retention strategies for rural Maryland physicians and advanced practice professionals. (MD Labor)

PILLAR 2: Promote Sustainable Access and Innovative Care for Rural Marylanders

To achieve a world-class health system for rural Marylanders, we will expand existing and implement new efforts to bring health care services into rural communities.

Immediate Impact Funds

Expand Access to Primary Care: Establish and expand primary care services in rural communities. (MHCC)

Increase Efficiency of Local Agency Operations: Strengthen rural LHD and AAA revenue capture and self sufficiency via vendors to provide coding, billing and revenue cycle management TA and explore LHD contracting and credentialing. (Garrett County HD)

Strengthen Emergency Trauma Response: Pilot Pre-hospital Blood Transfusion Program with rural EMS. (MIEMSS)

Expand School-Based Health Center Capacity: Support the expansion of hours, services and services areas and the procurement of mobile units. (MDH/ PHPA)

Expand and Optimize HIE Connectivity: Increase rural provider connectivity, pilot AI technology to improve clinical workflows, connect closed loop referral tools and support CBO billing. (CRISP)

Infrastructure to Spur Broader Telehealth Adoption: Develop a centralized telehealth technical infrastructure. (CRISP)

Transformation Funds

Sustainable Access Through Service Expansion and HIT Advances: Expand services to meet current demand and build long-term capacity to improve health outcomes and deploy technology-enabled chronic disease management. (MDH/ PHPA)

Mobile Health: Support regional mobile health programs, including chronic disease management, partnerships with EMS for community paramedicine and mobile health integrated health models and community-based care teams. (MDH/ PHPA)

Behavioral Health Services Expansion: Increase sustainable access to priority services across the full continuum of behavioral health care in rural areas. (MDH/ BHA)

Innovative Care: Prepare rural providers to participate in innovative, value-based care models. (HSCRC)

PILLAR 3: Empower Rural Marylanders to Eat for Health

Invest in infrastructure to support Marylanders’ access to nutritious, locally grown and raised Maryland foods.

Immediate Impact Funds

Post Harvest Infrastructure: Locate cold storage infrastructure within rural communities to expand food aggregation and distribution capacity for farms to supply local markets with fresh foods and enhance cold storage for food banks to enable distribution of fresh foods. (MDA)

NourishMD Expansion: Provide small grocers and mobile access points with funds for equipment purchases, minor renovations, technology infrastructure and marketing to create a sustainable business. (DHCD)

Create Demand for Healthy Foods: Local Health Departments will provide targeted nutritional education to improve food and physical activity behaviors among rural residents. (MDH/ LHDs)

Support Food Planning and Coordination: Establish a Rural Food Coordination program with a regional approach to convening and coordinating. (MDEM)

Transformation Funds

Food Aggregation: Food Aggregation and food hubs to increase the availability of affordable, local foods. (RMC)

Local Purchasing: New organizational purchasing strategies to pivot to

Subaward Opportunities & Competitive Procurements

Together with Maryland state agency partners, MDH will award a series of subawards totaling $163.7 million in Budget Period 1. A portion of these subawards, totaling $134.8 million, will be available through competitive procurement processes. Applications will be evaluated based on clear potential impact across the three RHTP focus areas. Funding will be distributed to the most promising and innovative projects,advancing CMS core principles of choice and competition.

2026 Competitive Procurement Opportunities: All competitive procurement details, including applications and timelines, will be posted to this website.

A public webinar will be held to provide an update regarding anticipated competitive opportunities:
Maryland RHTP Update: Anticipated Funding Opportunities
Friday, April 17 · 10:00 – 11:00 a.m.
Google Meet Joining Info: https://meet.google.com/ybc-nfcm-ktk

Or dial:(304) 518-4075;‬ PIN: ‪558 685 731‬#

Anticipated Funding Opportunities: Budget Period 1

PILLAR	INITIATIVE	PARTNER	FUNDING AVAILABLE	Anticipated Release of Funding Opportunity
Pillar 1 Transform the Rural Health Workforce	Workforce Data Clearinghouse	MDH	Competitive bid process	May/June 2026
	Apprenticeship Expansion: Employers RAMP Expansion for Allied Health: Employers	MD Labor	$3.5M	July 2026
	Pipeline Training Programs Provider Training, Recruiment and Retention Strategies	MD Labor	$15M	July 2026
Pillar 2: Promorte Sustainable Access & Innovative Care	Primary Care Practice Creation and Expansion	MHCC	$6.3M	April/May 2026
	Telehealth Needs Assessment	CRISP	Competitive bid process	May/June 2026
	Service Expansion and HIT Advances + Behavioral Health Expansion + Innovative Card	MDH + HSCRC	$73M	April/May2026
	Efficiency of Local Agency Operations	Garrett LHD for State	Competitive Bid Process	April/May 2026
	School-based Health Center Capacity	LHDs	$6.7M	July 2026
	Mobile Health Expansion	LHD by Region	$23M	April/May 2026
Pillar 3: Empower Rural Marylanders to Eat for Health	Post Harvest Infrastructure: Cold Storage for Producers	MDA	$3.7M	April/May 2026
	NourishMD Expansion: Small Grocers & Mobile Markets	DHCD	$1.6M	April/May 2026
	Food System Aggregation and Hubs Local Foods Purchasing Strategies	RMC	$4.7M	April 2026

Additional information regarding development of the Pillar 2 transformation funds opportunity can be found here.

Community & Partner Engagement

Continued partner and stakeholder engagement is essential to the state’s ability to implement programs that improve the health of our rural communities. Please consider ways to get involved and share your feedback.

Rural Health Transformation Committee
The Maryland Department of Health is committed to gathering robust input from rural communities to guide RHTP activities. The RHT Committee is composed of volunteers representing the perspectives of rural Maryland-based organizations and communities, offering feedback and input to help guide implementation of Maryland’s award. Quarterly RHT Committee meetings are open to the public. More information here.

Rural Heath Vendor Directory
The state is eager to help organizations and communities connect with service providers that can support RHTP efforts. This publicly available resource database will be updated periodically. To be listed in the Directory, please complete this form.

Frequently Asked Questions
Have additional questions? Please see the linked Frequently Asked Questions.

Listserv Updates
Sign up to receive periodic Maryland Rural Health Transformation Program updates in your inboxemail in-box: Sign up here!

Contact Us
Please reach out to [email protected] with any questions.

The Maryland Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $168,180,837.61 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

Last Updated: 04-10-2026