General · Funding Mechanics · 5 min read
How does RHTP funding flow from CMS to rural providers?
RHTP money moves in three stages: CMS awards a cooperative agreement to a state, the state issues its own solicitations (RFAs, grants, or contracts) tied to its approved plan, and rural providers and their partners apply to receive sub-awards and deliver the funded work. The state remains accountable to CMS for outcomes and spending.
Stage 1: CMS to the state
CMS issues each approved state a cooperative agreement. Unlike a hands-off grant, a cooperative agreement keeps CMS substantially involved: states report on milestones, spending, and outcomes, and CMS can shape how the work proceeds.
Stage 2: the state's own solicitations
Each state translates its federal plan into local funding mechanisms. These vary by state and may include competitive RFAs, formula grants to designated facilities, or contracts for specific services such as telehealth networks or workforce programs.
Stage 3: providers and partners deliver
Rural hospitals, clinics, behavioral health agencies, and their technology and service partners apply through the state's process. Because timelines and rules differ by state, watching your specific state's solicitations is essential.
Frequently asked questions
- Do all states use the same solicitation process?
- No. Each state designs its own mechanisms, so application formats, deadlines, and eligibility differ across states.
- Where can I see my state's opportunities?
- The RHTP Tracker aggregates state and federal RHTP documents and opportunities so you can monitor each state's solicitations as they appear.
Figures reflect the CMS Rural Health Transformation Program NOFO and the December 2025 award announcement. RHTP Tracker is an independent resource by Moodr Health and is not affiliated with CMS.