Hawaiʻi’s Rural Health Transformation Plan

The State of Hawai‘i will soon submit a proposal for funding under the Centers for Medicare & Medicaid Services (CMS) Rural Health Transformation Program (RHTP). RHTP is a new, federal initiative authorized under the One Big Beautiful Bill Act (Section 71401, Public Law 119-21) that empowers states to address the healthcare challenges faced by rural and remote communities. With Hawaiʻi’s unique geography and dispersed rural populations, this program offers an opportunity to build lasting solutions tailored to our needs.

Beginning in fiscal year 2026, the RHTP will provide $50 billion in funding nationwide over five years — $25 billion will be distributed equally to all approved states, with the remaining $25 billion allocated based on state-specific factors and CMS discretion.

States must submit one comprehensive plan to CMS by November 5th, 2025. This plan will describe how Hawaiʻi intends to use RHTP funds over the next five years. CMS will evaluate RHTP proposals by how they meet the following five Strategic Goals:

• Support rural health innovations and new access points to promote preventative health and address root causes of diseases. Projects will use evidence-based, outcomes-driven interventions to improve disease prevention, chronic disease management, behavioral health, and prenatal care.

• Help rural providers become long-term access points for care by improving efficiency and sustainability. With RHT Program support, rural facilities work together—or with high-quality regional systems—to share or coordinate operations, technology, primary and specialty care, and emergency services.

• Attract and retain a high-skilled healthcare workforce by strengthening recruitment and retention of healthcare providers in rural communities. Help rural providers practice at the top of their license and develop a broader set of providers to serve a rural community’s needs, such as community health workers, pharmacists, and individuals trained to help patients navigate the healthcare system.

• Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements. Develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs) to reduce healthcare costs, improve quality of care, and shift care to lower cost settings.

• Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, strengthen cybersecurity, and invest in emerging technologies.

If awarded, this grant would enable Hawai‘i to expand primary care services, strengthen behavioral health integration, and invest in workforce development for rural and neighbor island communities. The Office of the Governor, in collaboration with the Department of Health and Med-Quest Division will oversee the development of this application and will provide updates.

Residents are invited to collaborate by sharing information on community health needs, ideas for potential projects, and comments through the state’s public engagement hub at Engage.Hawaii.gov/RHTP.