CMS Establishes Office of Rural Health Transformation Nationwide
Key Takeaways
- The Centers for Medicare & Medicaid Services (CMS) formally created the Office of Rural Health Transformation (ORHT) within the Center for Medicaid and Children's Health Insurance Program (CHIP) Services (CMCS) to oversee a $50 billion Rural Health Transformation Program (RHT).
- The 5-year initiative runs through September 30, 2031, supporting state-led efforts to strengthen rural health systems and access to care nationwide.
- ORHT will provide oversight, technical assistance, and coordination to ensure accountability and long-term sustainability for rural health investments.
CMS has formally established the ORHT within the Center for Medicaid and CHIP Services (CMCS), solidifying federal oversight of a historic $50 billion initiative aimed at strengthening rural health systems across the US. The move follows the creation of the RHT Program earlier this year under President Trump’s Working Families Tax Cut legislation (Public Law 119-21).
ORHT will continue administering and overseeing the RHT, a 5-year effort designed to expand sustainable access to care in rural communities nationwide. CMS announced approved state awardees for the program on December 29, 2025. The initiative is scheduled to run through September 30, 2031.
The office’s responsibilities include guiding states in implementing their rural health transformation plans, providing technical assistance, coordinating federal and state partnerships, and ensuring robust oversight and accountability. CMS characterized the RHT Program as a generational investment in rural health infrastructure and care delivery.
“Healthy communities start with access to reliable care, no matter where you live,” said Health and Human Services Secretary Robert F. Kennedy, Jr. He emphasized that establishing ORHT is intended to ensure the investment delivers measurable and lasting results for rural families and health systems.
CMS leadership framed the new office as a structural step to support complex, multi-year implementation across diverse rural settings.
Clinical Implications
For payers, managed care organizations, and state Medicaid agencies, the establishment of ORHT signals a sustained federal commitment to rural health transformation with dedicated infrastructure for oversight and technical support. Rural providers often face workforce shortages, hospital closures, and limited access to specialty care, challenges that can affect quality, outcomes, and cost of care.
By centralizing leadership within CMCS, CMS aims to support states in adopting innovative care models and modernizing rural health infrastructure. The program’s scale and duration allow for longer-term planning and evaluation, which is critical for rural systems that require stable funding and policy alignment to achieve meaningful change.
For managed care stakeholders, ORHT’s focus on accountability and partnership may influence how rural delivery reforms are structured, monitored, and integrated into Medicaid and CHIP programs. The initiative may also shape future expectations for value-based care, access standards, and sustainability in rural markets nationwide.
Caprice Knapp, Principal Deputy Director of CMCS, added that states are “poised to undertake bold, ambitious work” under the program, and emphasized CMS’ commitment to partnership and stewardship throughout implementation.
Conclusion
The creation of ORHT formalizes federal leadership over a $50 billion investment in rural health. With dedicated oversight through 2031, ORHT positions CMS and states to pursue sustained, accountable improvements in access, infrastructure, and care delivery for rural communities nationwide.
Reference
The Centers for Medicare & Medicaid Services. CMS announces establishment of the Office of Rural Health Transformation. CMS.gov. December 29, 2025. Accessed January 9, 2026. https://www.cms.gov/newsroom/press-releases/cms-announces-establishment-office-rural-health-transformation
