What Is the Rural Health Transformation Program?
The Rural Health Transformation Program (RHTP) is a landmark $50 billion federal initiative created under Section 71401 of the One Big Beautiful Bill Act (Public Law 119-21). Administered by CMS, the program distributes $10 billion annually from FY2026 through FY2030 to all 50 states through cooperative agreements — no state matching funds required.
RHTP is designed to transform rural healthcare by investing in infrastructure, technology, workforce, and care delivery models that create lasting, sustainable improvements for rural communities. Learn more about RHTP on our hub page.
Five Strategic Goals
Maryland’s RHTP Program
Key Initiatives & Focus Areas
- Eastern Shore and Western Maryland telehealth expansion
- Behavioral health integration in rural primary care
- Health IT modernization and data sharing
- Rural workforce development
- Community health worker programs
Unique Aspects of Maryland’s Program
- Eastern Shore and Western Maryland have distinct rural health challenges despite proximity to Baltimore and DC
- Unique all-payer hospital system creates different RHTP implementation dynamics
- Strong state health information exchange (CRISP) infrastructure
- Chesapeake Bay communities with seasonal population fluctuations
- Agricultural and waterman workforce with occupational health needs
How Technology Supports RHTP in Maryland
The Interoperability Challenge
Rural healthcare facilities face significant technology gaps compared to their urban counterparts. Nationally, only 48% of rural hospitals have achieved basic interoperability, compared to 62% of urban hospitals. This data-sharing gap directly impacts care quality, coordination, and outcomes for rural patients.
RHTP’s Strategic Goal 5 specifically targets technology innovation, including a Technology Innovation Catalyst Fund that supports interoperability, telehealth, remote patient monitoring, AI-enabled health tools, and cybersecurity.
How Julota Addresses RHTP Technology Requirements
Julota is a cloud-based SaaS interoperability platform purpose-built for the challenges rural healthcare organizations face. Here’s how Julota supports RHTP goals in Maryland:
- FHIR-Native Interoperability: Julota’s platform supports HL7 FHIR APIs and G10 compliance, meeting the interoperability standards required by RHTP and the 21st Century Cures Act. Learn about Julota’s platform.
- Health Information Exchange Connectivity: Connect rural providers across Maryland to state and regional HIEs, enabling real-time data sharing that improves care coordination and reduces duplication.
- Care Coordination & Closed-Loop Referrals: Julota’s closed-loop referral management ensures patients don’t fall through the cracks — critical for rural communities where follow-up can require long-distance travel.
- MIH-CP & Community Paramedicine Support: Julota’s MIH-CP solution supports the mobile integrated health and community paramedicine models that many states are funding under RHTP.
RHTP Eligibility in Maryland
RHTP funds flow from CMS to Maryland through a cooperative agreement. The state then distributes funds to eligible subrecipients through competitive processes.
Eligible Organization Types
- Critical Access Hospitals (CAHs) — Rural hospitals with 25 or fewer beds
- Federally Qualified Health Centers (FQHCs) — Community health centers serving underserved populations
- Rural Health Clinics (RHCs) — Clinics in designated shortage areas
- Community Behavioral Health Providers — Including Certified Community Behavioral Health Clinics (CCBHCs)
- Emergency Medical Services (EMS) — Ambulance services and first responders
- Tribal Health Organizations — Indian Health Service and tribal facilities
- Local Health Departments — County and regional public health agencies
- Universities and Training Programs — Workforce development partners
How to Apply
Organizations in Maryland should contact Maryland Department of Health for subrecipient application details. Most states distribute RHTP funds through competitive RFP processes that require demonstrating alignment with the state’s approved Rural Health Transformation Plan.
Key compliance requirements include SAM.gov registration, adherence to 2 CFR 200 uniform guidance, and commitment to quarterly and annual reporting on performance metrics and milestones.
Key Questions About RHTP in Maryland
How much RHTP funding did Maryland receive?
Maryland received RHTP funding as part of the FY2026 allocation. Despite proximity to major metro areas, Maryland's Eastern Shore and Western Maryland regions face significant rural health challenges.
What is Maryland's Rural Health Transformation Program?
Maryland's RHTP targets healthcare transformation on the Eastern Shore and in Western Maryland, focusing on telehealth, behavioral health, health IT, and workforce development.
Who is eligible for RHTP in Maryland?
Eligible organizations include hospitals, FQHCs, Rural Health Clinics, behavioral health providers, EMS agencies, and other healthcare organizations in Maryland's rural regions.
What technology does Maryland's RHTP fund?
Maryland's RHTP supports telehealth expansion, CRISP health information exchange connectivity, EHR modernization, remote patient monitoring, and cybersecurity improvements for rural facilities.
How does Maryland's all-payer system affect RHTP?
Maryland's unique all-payer hospital system creates distinct RHTP implementation dynamics, with opportunities to align RHTP-funded technology investments with existing value-based payment models.
How can Maryland rural providers apply for RHTP?
Maryland providers should contact the Maryland Department of Health for RHTP subrecipient information and monitor state announcements for competitive application opportunities.
Ready to Build RHTP-Ready Infrastructure in Maryland?
Julota helps rural healthcare organizations meet RHTP interoperability requirements with a cloud-based platform that connects providers, enables data sharing, and supports care coordination across your community.