About the Rural Health Transformation Program

A notice of funding opportunity was released on September 15, 2025, by the Centers for Medicare and Medicaid to help states “support rural communities across America in improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem.”  On December 29, 2025, Massachusetts was awarded $162 million for the first-year award.

Vision: A Commonwealth where rural communities thrive, and well-being is achievable for all. 

To advance this vision, the Rural Health Transformation Program proposal focuses on three overarching goals: 

• Expand access to essential healthcare services for rural residents.
• Improve health and well-being through targeted initiatives and partnerships.
• Strengthen systems, policies, and investments to meet the unique needs of rural communities. 

For additional information on the Federal Rural Health Transformation Program: Rural Health Transformation (RHT) Program | CMS 

Rural Health Challenges and Opportunities for Transformation 

In Massachusetts, 160 of 350 towns are classified as rural, covering over half the state’s land and home to roughly 10% of the population (700,000+), including many vulnerable groups such as seasonal workers, tribal members, older adults (60+), and low-income families.  

The DPH State Office of Rural Health (SORH) defines rural communities based on federal criteria, population size and density, and the presence of small or critical access hospitals. Areas are categorized as Rural 1 or Rural 2 and grouped into 18 rural clusters to guide state policy.  

Rural communities experience major healthcare disparities in access and outcomes due to limited providers, aging infrastructure, and systemic decline in local health services. These areas face higher chronic disease and behavioral health burdens, workforce shortages, and financial instability, resulting in poorer health outcomes compared to non-rural regions. Addressing these challenges requires targeted investments in workforce development, infrastructure, and access to primary and specialty care. 

Rural Health Transformation in Massachusetts

The Massachusetts Rural Health Transformation Program is structured around seven Initiatives, each of which contains numerous activities, to transform rural healthcare across the Commonwealth: 

1. Population Health Advancement: Improve clinical infrastructure, increase coordination and expand payment methodologies to advance rural health providers’ value-based care and efforts to lower cost and increase quality of care.
2. Innovation in Rural Care Models: Facilitate the introduction and redesign of models in rural Massachusetts to increase access, broaden service availability, and improve efficiencies in the delivery of health care.
3. Training Healthcare for Retention, Innovation, & Excellence (THRIVE): Strengthen the full continuum of the healthcare workforce in rural communities with targeted activities focused on workforce development, recruitment, and retention.
4. Healthy Rural Communities: Support community-informed and led prevention activities to increase opportunities and address gaps related to the root causes of health.
5. EMS Service Integration: Investments and programs to increase viability, integration, and expand role of EMS in rural communities.
6. Enhancing Technology Interoperability and Connectivity: Improving technological infrastructure of rural health providers to increase connectivity, create efficiencies, and support better outcomes.
7. Facility Modernization & Re-Use: Support minor renovations of rural facilities to optimize space and expand access.  

We invite all parties to join us in this effort and to stay informed about progress and opportunities for engagement. To reinforce EOHHS’s ongoing commitment to community and public engagement, the agency will continue outreach efforts through the creation of a Community Advisory Council, initiative-specific workgroups, public information sessions, and partnerships with existing rural advisory bodies. More information will be shared as it becomes available.