North Carolina Seeks $1 Billion to Transform Rural Healthcare Access
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A comprehensive plan submitted to the Centers for Medicare & Medicaid Services (CMS) aims to deliver $1 billion in federal funding over five years to dramatically improve healthcare access and outcomes across 85 of North Carolina’s 100 counties. The Rural Health Transformation Plan, developed by the North Carolina Department of Health and Human Services (NCDHHS), proposes a sweeping overhaul of rural healthcare systems, addressing critical challenges faced by nearly 3 million residents.
The initiative seeks to leverage $200 million annually to ensure all North Carolinians, regardless of location, have access to high-quality, affordable care. CMS is expected to announce funding decisions by December 31, 2025, with program implementation slated to begin in early 2026.
A Collaborative Approach to Rural Health
The plan is the result of extensive collaboration with over 420 stakeholders, including rural hospitals, community health centers, local health departments, Tribal communities, faith-based organizations, and residents. This broad engagement underscores a commitment to addressing the unique needs of each rural community.
“Our plan reflects North Carolina’s commitment to ensuring that every North Carolinian, no matter where they live, has access to high-quality health care,” stated Governor Josh Stein. “North Carolina is on the cutting edge of technology and innovation, and our application for the Rural Health Transformation Program shows that we’re ready to continue our leadership in rural health care.”
According to a senior official at NCDHHS, rural healthcare providers are vital to their communities, working tirelessly to deliver care. North Carolina, possessing the second-largest rural population in the United States after Texas, faces specific hurdles, notably a strained healthcare workforce.
Six Key Strategies for Transformation
The North Carolina Rural Health Transformation Plan centers around six core strategies designed to fundamentally reshape rural healthcare delivery:
- Launching a locally governed “NC ROOTS” Hub to integrate medical, mental health, and social support services.
- Expanding programs focused on prevention, chronic disease management, and nutrition.
- Increasing access to mental health services, including treatment for substance use disorder.
- Investing in the rural health workforce to attract and retain qualified professionals.
- Supporting rural providers in transitioning to value-based care models.
- Enhancing technology in healthcare to improve access and efficiency.
A key component of this strategy is the proposed Rural Health Infrastructure Fund (RHIF), designed to provide rural healthcare providers with the technology needed to modernize their practices.
Statewide Impact and Federal Partnership
On November 21, NCDHHS staff will brief members of North Carolina’s congressional delegation and the NC General Assembly, emphasizing the program’s goals, its potential statewide impact, and the critical role of federal partnership in addressing the underlying causes of health disparities.
The program is expected to support over 400 rural health facilities and is guided by a statewide steering committee comprised of representatives from NCDHHS’s Office of Rural Health, divisions of Medicaid, Public Health, and Mental Health, alongside universities, community colleges, Community Health Centers, Rural Health Clinics, small rural hospitals, school-based clinics, and local partners.
A public notice will be issued following CMS approval, with detailed information regarding the funding process to be released in early 2026. North Carolinians are encouraged to learn more about the Rural Health Transformation Program by visiting www.ncdhhs.gov/rhtp.
This initiative represents a significant investment in the health and well-being of rural North Carolinians, promising a more equitable and accessible healthcare system for all.
