$50 Billion Sitting There: How to Access Rural Health Transformation Funding
Episode Overview
There is $50 billion in federal funding specifically designated for healthcare organizations like yours - and most health center leaders either don't know about it, think they don't qualify, or have no idea where to start. In this episode, Jill Steeley breaks down the Rural Health Transformation Program (RHTP) created by the One Big Beautiful Bill (HR 1), signed into law on July 4, 2025. She walks you through eligibility requirements, core program priorities, and the technology investments that can anchor a winning application - all with an eye toward helping you act before your state's funding window closes.
In This Episode, You’ll Learn:
- What the Rural Health Transformation Program is, where the money comes from, and how states are distributing it
- Eligibility requirements—including a critical nuance most health centers miss about serving rural populations
- The core program requirements CMS expects you to meet with this funding
- Why Health IT modernization is the most underestimated opportunity in the program
- Four specific technology tools Jill recommends evaluating as part of your RHTP strategy
- How to get a free eligibility assessment to know where your health center stands
Key Takeaways
"There is $50 billion sitting in a federal program designed specifically for healthcare organizations like yours. Most health center leaders either haven't heard of it, think they don't qualify, or have heard of it but have no idea where to start."
— Jill Steeley
"FQHCs do not have to be physically located in a rural area to be eligible. What matters is whether you are serving rural patient populations."
— Jill Steeley
"Generic applications are not going to win. State-aligned applications will."
— Jill Steeley
"If your state's application window closes before you've submitted, that's potentially millions of dollars that won't be available to you until the next funding cycle—and there may not be one."
— Jill Steeley
Funding Snapshot: The Rural Health Transformation Program
- Created by HR 1 (the “One Big Beautiful Bill”), signed into law July 4, 2025
- Administered by CMS (Centers for Medicare and Medicaid Services)
- Total investment: $50 billion over 5 years (FY 2026–2030), $10 billion per year
- Every state received an award in December 2025, with an average of ~$200 million per state per year
- Sample state awards: Texas $281M, Alaska $272M, California $234M, Montana $233M
- States are the primary grantees—they are now issuing sub-award RFPs for eligible organizations
- Active or pending sub-award windows: Colorado, Montana, Michigan, Washington, North Dakota, and others
- Funds must be spent by October 1, 2032—unspent money reverts to the U.S. Treasury
Who Is Eligible
Organizations explicitly named as eligible for RHTP sub-awards:
- Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes
- Certified Community Behavioral Health Clinics (CCBHCs)
- Rural Health Clinics
- Community Mental Health Centers
- Section 330 grantees
IMPORTANT: FQHCs do not have to be physically located in a rural area. If your patient panel includes people who live in rural counties—even if your clinic is in a suburban or urban location—you may still be eligible. Don’t disqualify yourself before doing an actual assessment.
Core Program Requirements
- No Duplication of Existing Funding
These funds cannot replace or duplicate money already received through Medicaid, 340B, or your Section 330 grant. RHTP is designed to be additive—funding new activities and expanded capacity, not existing revenue streams. This distinction is critical for both your application narrative and ongoing compliance.
- Spending Caps
- Administrative overhead: limited to 10% of award
- Infrastructure and facility upgrades: capped at 20% of award
- The remaining funds must go toward actual program delivery
- State Priority Alignment
CMS rewards alignment with your state’s specific RHTP plan. States submitted priorities documents when they applied for funding. Organizations that read that document and build their narrative directly around the state’s goals score significantly higher in sub-award competitions.
CMS Priority Use Areas
Your application needs to show how your proposed work maps to these explicitly named priorities:
- Behavioral health integration and opioid use disorder treatment
- Chronic disease management
- Telehealth expansion
- Workforce recruitment and retention (especially providers committing to rural practice for at least 5 years)
- Health IT modernization and cybersecurity
- Maternal care access
- Rural hospital sustainability
- Value-based care model development
Technology Deep Dive: The Most Underestimated Opportunity
Health IT modernization is consistently the most underfunded and underestimated area in health centers—and it’s one of the strongest fundable uses of RHTP dollars. When you can show that a specific technology investment will reduce unnecessary ED visits, close care gaps, improve chronic disease outcomes, or increase your clean claims rate, that is a compelling, documented outcomes-tied investment that CMS is explicitly looking for.
Jill has vetted each of the following tools, seen multiple demos, and referred clients who have had measurable success. She also discloses affiliate relationships with each company.
1. Vital Interaction — Patient Engagement & Retention
Vital Interaction is a patient engagement and retention platform built specifically for healthcare organizations. Unlike generic text reminder systems, it sends health center-branded communications (text, phone, and video messages from a patient’s actual provider) that patients actually respond to.
Key results for FQHCs:
- 20% decrease in no-show rates
- 10% increase in completed appointments
- More than 20% increase in revenue for participating health centers
What sets them apart: Founded by healthcare professionals who also have IT expertise—not the other way around. The platform integrates with your EHR and is designed around how healthcare workflows actually operate.
Special offer (up to 50% off): https://guidance.vitalinteraction.com/jill-steeley
Click here to listen to Jill’s full interview with Vital Interaction on the Community Health Collective Podcast
2. Athelas — AI Scribe, Remote Patient Monitoring & Revenue Cycle
Athelas is a comprehensive healthcare operations platform that integrates advanced AI across three core areas:
AI Scribe (Ambient Documentation)
Athelas’s ambient AI adapts to each clinician’s unique style and captures chart notes automatically—only documenting the clinically relevant portions of a patient encounter. Notes sync directly to the EMR, and integrated AI reviews every note for completeness and compliance. Benefits include:
- Providers can maintain eye contact and focus on the patient, not a laptop
- AI suggests appropriate billing codes—reducing undercoding (a widespread issue in health centers)
- Significant time savings for clinicians, reducing after-hours documentation burden
Remote Patient Monitoring
Athelas monitors patients via internet-connected smart devices, providing continuous health data and AI-powered analysis for chronic conditions and vital signs—enabling proactive rather than reactive care.
Revenue Cycle Management
AI-powered full-cycle RCM with no double entry or screen switching. Key metrics:
- 97% first-pass approval rate
- 2% average denial rate
- Insurance AR >90 days at 10% (vs. 45% industry average)
- $10 billion flowing through their platform annually across thousands of clients
As the Executive Director of Lanai Community Health Center noted, Athelas returns time to providers so they can focus on human connection with staff, patients, and the community.
Book a call with Athelas and get special pricing as one of Jill’s podcast listeners.
Watch for an upcoming Community Health Collective podcast episode with Melissa Erlandson releasing on March 18th.
To watch Jill’s full episode on the Athelas Taking Back Healthcare podcast click here
3. RetroCAID — Retroactive Medicaid Eligibility Recovery
RetroCAID (by Fix Healthcare Technology) passively monitors benefit profiles for uncompensated encounters daily, automatically identifying when patients become eligible for retroactive Medicaid reimbursement—and then works to get those claims paid.
Why this matters for your RHTP application: The non-duplication requirement means you need a precise, accurate picture of what Medicaid is already covering. RetroCAID gives you that clarity—making it significantly easier to demonstrate that your RHTP-funded activities are genuinely additive. That’s not just a financial benefit; it’s a compliance advantage.
Key facts:
- FQHC clients recover an average of $9,000–$35,000 more per month in previously uncollected claims
- Operates on 100% contingency—no upfront costs, month-to-month contract
- Serves 4,500+ health facilities across 49 states
- Does not integrate with or require access to your EHR—works directly with your state Medicaid office
Schedule a call with RetroCAID: https://fixht.com/meeting/retrocaid-qa-jsteeley/
To listen to Jill’s podcast episode with Fix Healthcare Technology’s CEO, Howard Archer, click here.
4. ERA Group — Cost Reduction & Expense Optimization
ERA Group is a global network of expert cost consultants that helps organizations reduce overhead and supply chain costs using proprietary pricing data from thousands of clients. For community health centers, their model is risk-free—clients only pay if savings are identified and delivered.
What they review:
- Medical and pharmacy supplies
- Office and tech expenses
- Facility management and operational supplies
- Staffing and HR services
- Language translation, reference labs, and call centers
- Small parcel delivery, waste management, and more
Results:
- One Community Health (an FQHC in Sacramento, CA): $646,000 in annual savings identified across seven cost categories
- Another client: Over $3 million in savings across more than a dozen expense categories
ERA Group’s PhD-level auditors analyze your spending patterns, identify invoicing errors and consolidation opportunities, and negotiate better rates on your behalf—freeing your team to focus on patient care.
To schedule a call with John Carpenter at ERA Group, email [email protected]
What to Do Right Now
- Check whether your state has an active RHTP sub-award RFP—and find out when the window closes
- Download your state’s rural health transformation priorities document and read it before drafting your application
- Evaluate which of the technology tools mentioned align with your state’s priorities
- Review your 340B, Medicaid, and Section 330 revenue streams so you can clearly demonstrate additionality
- Take Jill’s free eligibility assessment to determine whether and how strongly your organization qualifies
Free Eligibility Assessment
Jill has built a free Rural Health Transformation Program eligibility assessment—a short tool that walks you through the key eligibility indicators, including your organizational type, rural population service, funding streams, data readiness, and state priority alignment. At the end, you receive a score and clear guidance on your next steps: strong candidate, likely eligible, partial fit, or monitor and revisit.
To request your free assessment: Email [email protected] with “Rural Health Assessment” in the subject line.
You can also schedule a call with Jill to discuss this funding and determine whether your organization is eligible.
Mentioned in This Episode
- Vital Interaction — Patient engagement and retention platform. Up to 50% off: https://guidance.vitalinteraction.com/jill-steeley
- Athelas — AI scribe, remote patient monitoring, and revenue cycle management. Schedule a call: https://hello.athelas.com/c/Melissa_Erlandson#/select-time
- RetroCAID — Retroactive Medicaid eligibility recovery. Schedule a call: https://fixht.com/meeting/retrocaid-qa-jsteeley/
- ERA Group — Cost reduction and expense optimization consultants. Schedule a call with John Carpenter: [email protected]
- Free RHTP Eligibility Assessment — Email [email protected] with “Rural Health Assessment” in the subject line
- CEO Bootcamp — Jill’s 5-month program for FQHC executives, co-led with Steve Weinman. Learn more at www.fqhc-ceo.com
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Have a topic request or feedback? Jill would love to hear from you. [email protected]
