HHS Region 7 · Iowa Health and Human Services — Healthy Hometowns
Program Overview
The Iowa Rural Health Transformation Program, led by Iowa Health and Human Services with multi-year federal support, advances through pilot and competitive RFP phases to strengthen rural health infrastructure and sustain Critical Access Hospitals and rural providers. Current implementation emphasizes collaborative hub-and-spoke care models—especially for oncology and cardiovascular health—network expansion, workforce recruitment, telehealth integration, and evidence-based initiatives managed via IowaGrants.gov. The structured plan focuses on building Health Hubs, expanding cancer screening and treatment, co-locating rural providers, enhancing health information exchange, and mobile EMS community care. Current structured plan tracks 5 key initiatives and 10 strategic goals.
Updated
County-level estimates averaged across Iowa — % of adults 18+ unless noted. Delta vs US county average shown in red/green.
pp = percentage points vs US county average
County Drilldown (99)
| County | Pop | Poverty | Uninsured |
|---|---|---|---|
| Polk County | 503,175 | 10.3% | 7.1% |
| Linn County | 230,004 | 9.4% | 6.2% |
| Scott County | 174,608 | 11.5% | 7.3% |
| Johnson County | 156,639 | 17.1% | 7.2% |
| Black Hawk County | 131,049 | 14.9% | 9.0% |
| Dallas County | 107,968 | 6.3% | 4.8% |
| Woodbury County | 106,247 | 14.0% | 10.7% |
| Story County | 100,466 | 18.2% | 5.6% |
| Dubuque County | 99,030 | 9.7% | 5.8% |
| Pottawattamie County | 93,424 | 12.1% | 8.0% |
| Warren County | 54,409 | 5.1% | 2.7% |
| Clinton County | 46,268 | 13.2% | 8.6% |
AI source: IA - 2026 - Iowa first in the nation to award RHTP funding
AI auto-updated Oct 12, 2026
API refreshed May 7, 2026
GuideGetting ready for Year 2 in Iowa?How to prepare for RHTP Year 2 funding →
Source: CMS State Data Maps ↗ · checked Nov 11, 2026
Federal awards to date: $425,047,721.03 (Year 1 $209.0M + Year 2 $216.0M)
Initiatives (5)
CMS stages run from Stage 0 (planning) to Stage 5 (full implementation). Complete In progress Not started
Key signals are summarized here. Open the source for the supporting detail.
Centers for Medicare & Medicaid Services (CMS)
Grouped files
No related documents
No linked documents found.
Centers for Medicare & Medicaid Services (CMS)
Grouped files
9 related documents
1,232,642 rural residents
Iowa continues to implement its Rural Health Transformation Program, Healthy Hometowns, with over $78 million already awarded and new grant opportunities in process. The state has launched key initiatives such as Hometown Connections and the Combat Cancer Health Hub Program, with multiple RFPs for cancer, cardiovascular, maternal health, residencies, and equipment acquisition active or recently closed. State dashboards confirm ongoing statewide rollout, with $226.2M in funding listed and active procurement. This sustained activity aligns with Iowa's telehealth and prevention strategies. State opportunities: 1 active (1 closing soon, 8 past/closed), $226.2M listed funding. Key opportunities: Iowa Cardiovascular Health Hub and Spoke Networks (RFP COMPADM26007); Iowa School Based Services (RFP MEDIOMC26023); Iowa Best and Brightest Medical Equipment Program (RFP PHTHORC26011). Strategy alignment: supports telehealth, prevention, maternal health priorities.
Iowa’s Rural Health Transformation Program (RHTP), led by Healthy Hometowns, advances a statewide hub-and-spoke approach to revitalizing rural healthcare delivery. The strategy continues to focus on integrated clinical and specialty health networks, targeted investments in medical equipment and workforce recruitment, and competitive RFPs to strengthen care coordination and access. Major initiatives emphasize investments in cancer, maternal, cardiovascular, EMS, and chronic disease care, with public dashboards supporting transparency and measurable outcomes.
Model
Statewide hub-and-spoke model integrating rural hospitals, clinics, EMS/mobile integrated health, multi-agency co-location hubs, and specialty networks (oncology, maternal, cardiovascular, transport services) to deliver coordinated, high-quality, and patient-centered rural population health.
Key Initiatives (5)CMS official list ↗
Supporting activities (8)
• Establish and expand Combat Cancer Health Hubs: increase chemotherapy and specialty cancer services at spoke sites, enable virtual tumor boards, expand tele-oncology, facilitate record/data exchange, implement referral and telehealth agreements, develop sustainable payment models, and ensure compliance with Commission on Cancer standards.
• Establish Maternal Health Hub and Spoke Networks: expand provider partnerships, implement telehealth, recruit providers, invest in equipment, and integrate behavioral/social supports in rural maternal care.
Timeline: RHTP implementation is set for FY2026–2031, with primary RFPs issued July–September 2026, contract awards beginning October 31, 2026, initial services launched by 2027, and the contract period continuing through September 2031.
Combat Cancer: Prevent and Treat
Communities of Care
EMS Community Care Mobile
Health Information Exchange
Hometown Connections
State Policy Action commitments (4 of 19)
Statewide initiatives target lung, breast, colorectal, skin, and prostate cancers with enhanced screening, treatment, and supportive care.
Initiatives like Hometown Connections and Health Information Exchange aim to improve rural healthcare connectivity and coordination.
EMS Community Care Mobile works to expand emergency medical services tailored for rural community needs.
IA - 2025 - Iowa RHTP (Healthy Hometowns)
Supporting source: Iowa Project Narrative
IA - 2025 - RHTP – Healthy Hometowns
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IA - 2026 - Healthy Hometowns (e7db6c)
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IA - 2026 - Healthy Hometowns
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IA - 2025 - Iowa RHTP (Healthy Hometowns) (15e303)
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IA - 2025 - Healthy Hometowns Iowa’s RHTP
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IA - 2026 - Iowa Federal RHTP Award (FY2026-FY2030)
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IA - 2026 - Iowa first in the nation to award RHTP funding
Gov. Reynolds press release, 2026-01-30: Iowa first in the nation to award RHTP funding (PHTHORC26009 $66.0M + PHTHORC26010 $12.6M)
IA - 2026 - Best and Brightest – Rural Healthcare Workforce Recruitment
Best and Brightest - Rural Healthcare Workforce Recruitment (Notice of Intent to Award)
Iowa Department of Health and Human Services
Due Nov 17, 2026· ⏰ 5 days left
5 related documents
IA - 2026 - Request for Information Healthy Hometowns Cardiovascular Health Hub and Spoke Networks of Care
Supporting source: Iowa Cardiovascular RFI and submission guidance
IA - 2026 - RFI# COMPADM26007 Regarding Healthy Hometowns Cardiovascular Health Hub and Spoke Networks of Care
Reference source: How to Submit in Response to RFI# COMPADM26007
IA - 2026 - funding opportunities
Auto-linked by identifier
IA - 2026 - Cardiovascular Health Hub and Spoke networks
Notice of Intent to Release — Cardiovascular Health Hub and Spokes (RFP COMPADM26007)
IA - 2026 - Healthy Hometowns Cardiovascular Health Hub Program Request For Proposal # Compadm26007
Primary source
Iowa Department of Health and Human Services
Grouped files
1 related document
IA - 2026 - Notice of Intent to Release RFP PHTHOPD27001 - Public Health Lead Entities
Official Iowa HHS Notice of Intent
Iowa Department of Health and Human Services
Due Sep 23, 2026
1 related document
IA - 2026 - Notice of Intent to Release for School Based Services
By budget period: BP1 $11.0M (from the award date, the source's publish date, or RCJ having recorded the award before Budget Period 2 began)
| FY↓ | Awardee↕ | Amount↕ | Activity↕ | Source |
|---|---|---|---|---|
| 2026BP1 | Combat Cancer Health Hub Program Establishes hub-and-spoke networks of cancer care across Iowa, connecting a central specialized cancer center with local clinics to expand access, provide screenings, telehealth, workforce recruitment, and equipment purchases. | $11.0M | Population Health | |
| 2026BP1 | Adair County Memorial Hospital Supports recruitment of MD/DO physician for rural hospital healthcare workforce. | Not disclosed | Workforce | |
| 2026BP1 | Avera Holy Family Hospital Funds rural recruitment of family practice physician (MD/DO) in Emmet County. | Not disclosed | Workforce | |
| 2026BP1 | Boone County Hospital Supports hiring of physician assistant and primary care physician for Boone County Hospital. | Not disclosed | Workforce | |
| 2026BP1 | Cass County Memorial Hospital DBA Cass Health Funds recruitment of physician (MD/DO) or ARNP for rural hospital. | Not disclosed | Workforce | |
| 2026BP1 | CHI Health Mercy Corning Supports recruitment of internal medicine physician and registered nurses for Adams and Taylor Counties. | Not disclosed | Workforce | |
| 2026BP1 | Central Iowa Hospital Corporation Centers of Excellence (RFP PHTHORC26008) | Not disclosed | Centers of Excellence | |
| 2026BP1 | Decatur County Hospital Centers of Excellence (RFP PHTHORC26008) | Not disclosed | Centers of Excellence | |
| 2026BP1 | Guttenberg Municipal Hospital Centers of Excellence (RFP PHTHORC26008) | Not disclosed | Centers of Excellence | |
| 2026BP1 | Iowa Specialty Hospital Centers of Excellence (RFP PHTHORC26008) | Not disclosed | Centers of Excellence |
Senator Grassley announced a federal funding commitment of $216 million dedicated to Iowa rural healthcare under the Republicans Working Families Tax Cuts Law. The announcement underscores federal support for the state’s rural health infrastructure.
Iowa won a $209 million federal award under CMS's Rural Health Transformation Program to implement Healthy Hometowns. The initiative aims to transform rural health care by enhancing partnerships, cancer care, integrated services, health IT, and mobile care programs.
Core Initiatives
Iowa received over $216 million from CMS for its multi-year Health Transformation Program, Healthy Hometowns.
This RFP enables organizations to apply as hub-and-spoke networks to strengthen cardiovascular and chronic disease care for rural Iowans. Federal RHTP funds are used to expand access to advanced diagnostics, interventions, rehabilitation, and tele-cardiology. The procurement offers flexible options for applicants to serve as regional hubs, expand hub capacity in underserved regions, or sustain local spokes focused on prevention and management. Key contacts: Jennifer Zepeda jennifer.zepeda1@hhs.iowa.gov; iowagrants.helpdesk@hhs.iowa.gov Event schedule: - RFP Issued - 09/21/2026 - CT - www.IowaGrants.gov - Letter of Intent (Mandatory) - 10/19/2026 - CT - Jennifer.Zepeda1@hhs.iowa.gov - Round 1 Questions Due - 10/05/2026 - 12:00 PM CT - www.IowaGrants.gov - Round 2 Questions Due - 10/30/2026 - 12:00 PM CT - www.IowaGrants.gov - Applications Due - 11/17/2026 - 12:00 PM CT - www.IowaGrants.gov - Applicant Oral Presentations - 01/11/2027 - CT - TBD - Post Notice of Intent to Award - 01/19/2027 - CT - https://hhs.iowa.gov/about/funding-opportunities/notice-intent-award - Contract Year 1 Period - 2027-01-29 to 2027-10-30 - Iowa
Event Schedule
Contacts
Core Initiatives
Iowa's Department of Health and Human Services is soliciting applications for the development of accredited medical residency programs with mandatory rural rotations in key specialties. Up to $9 million is available for up to twelve awards statewide, with a maximum of $750,000 per contract for the base term. The RFP aims to expand the physician workforce in rural areas, strengthen GME infrastructure, and improve rural health access. Key contacts: Mike Drottz Michael.drottz@hhs.iowa.gov; iowagrants.helpdesk@hhs.iowa.gov Event schedule: - RFP Issued - November 2, 2026 - CT - Round 1 Questions Due - November 16, 2026 - 12:00 PM CT - Responses Posted By (Round 1) - November 24, 2026 - CT - Final Questions Due - December 4, 2026 - 12:00 PM CT - Final Responses Posted By - December 14, 2026 - CT - Applications Due - December 28, 2026 - 4:00 PM CT - www.IowaGrants.gov - Release of Names of Applicants - December 30, 2026 - CT - Notice of Intent to Award - January 10, 2027 - CT - https://hhs.iowa.gov/about/funding-opportunities/notice-intent-award
Event Schedule
Contacts
Core Initiatives
Support page providing instructions on how to log in and register for IowaGrants, including links and contact information for user assistance.
Iowa plans to release an RFP in mid-2026 to develop a rural residency program in Internal Medicine or Obstetrics/Gynecology. This initiative focuses on building rural healthcare workforce capacity through accredited residencies. Event schedule: - Question and answer period - July 2026 - Deadline for bid proposals - July 2026 - Award contract(s) - August 2026
Healthy Hometowns is Iowa’s ambitious rural health transformation plan proposing up to $1 billion over 5 years from CMS Rural Health Transformation Program focused on building Health Hubs, workforce expansion, cancer care, health information exchange, community care, and EMS mobile telehealth services.
Core Initiatives
Healthy Hometowns is Iowa's submission to the Rural Health Transformation Program, awarded $209 million for its first year, aiming for $1 billion over five years. The program focuses on five key initiatives: Hometown Connections (network development and workforce), Combat Cancer (screening and treatment), Communities of Care (co-location and chronic disease management), Health Information Exchange, and EMS Community Care Mobile (maternal health and mobile integrated care). Public dashboards and new funding opportunities are available for transparency and ongoing engagement with communities. Key contacts: [email protected] Event schedule: - Iowa awarded $209 million for first year - December 29, 2025 - New Healthy Hometowns RFP for Combat Cancer Health Hub Program; Maternal Health Hub and Spoke Networks of Care RFI - May 15, 2026 - Graduate Medical Education Approval, New Awardees, and Dashboards Announced - June 18, 2026
Event Schedule
Contacts
Core Initiatives
The Healthy Hometowns program aims to reduce avoidable emergency department visits, increase local care and telehealth services, and improve provider-to-population ratios in rural Iowa. It includes multiple initiatives focusing on network development, workforce recruitment, cancer prevention, chronic disease management, health information exchange, and EMS integration.
The Iowa Rural Health Transformation Program (Healthy Hometowns) application outlines comprehensive strategies to address chronic disease, cancer, workforce gaps, EMS, and health information exchange inequities facing rural Iowa. Data tables document substantial disparities in access, health outcomes, workforce distribution, and system performance between rural and urban areas. The technical alignment matrix details multi-sector integrated approaches, including hub-and-spoke models, technology adoption, community partnerships, and targeted workforce initiatives.
Event Schedule
Core Initiatives
This application outlines Iowa's strategy to leverage the Rural Health Transformation Program for significant improvements in rural health care. Key initiatives include care coordination, specialty access, workforce recruitment, cancer prevention and treatment, telehealth investments, health information exchange expansion, and EMS innovation. The plan targets measurable improvements in access, local service availability, care coordination, and rural health outcomes.
Sen. Chuck Grassley announced that Iowa will receive $216 million in federal funds from the Working Families Tax Cuts Act. This funding, distributed through the Rural Health Transformation Program, supports rural healthcare workforce recruitment, retention, cancer care, and medical equipment in Iowa. Over five years, Iowa is guaranteed at least $100 million annually from this fund.
2031
RHTP program performance targets achieved
prior to December 31, 2028
Reestablishment of Presidential Fitness Test
December 31, 2028
Nutrition CME requirements and network participation deadline
December 31, 2028
Reestablish Presidential Fitness Test
Iowa commits to reestablishing the Presidential Fitness Test by December 31, 2028.
December 31, 2028
Nutrition CME Requirement for Physicians
Iowa commits to including nutrition within continuing medical education requirements for physicians by December 31, 2028.
June 30, 2028
Chemotherapy Provision Deadline at Spokes
Spoke sites must provide or increase the provision of chemotherapy by June 30, 2028.
by September 30, 2027
Telehealth Equipment Procurement
By September 30, 2027, Contractor must have procured telehealth equipment or provided attestation of existing telehealth equipment to support providing high risk OB or neonatal transport services.
July 15, 2027; July 15, 2028; July 15, 2029; July 15, 2030; July 15, 2031
Annual Reports Due
Annual Reports are due July 15, 2027, July 15, 2028, July 15, 2029, July 15, 2030, and July 15, 2031.
July 15, 2027
First Annual Report Due
Annual report due July 15, 2027.
January 29, 2027
Contract Term Begins
The anticipated total Contract Term is from January 29, 2027, to September 30, 2031.
December 31, 2026
Enactment of outpatient behavioral health CON removal
December 31, 2026
Certificate of Need Legislative Change
Iowa will implement legislative change for Certificate of Need to remove outpatient behavioral health care from review requirements by December 31, 2026.
IA - 2026 - Iowa Awarded $216 Million in Federal Funding to Expand RHTP
IA state summary updated: transformationStrategy initiatives: 12 -> 5
Iowa’s Rural Health Transformation Program (RHTP), led by Healthy Hometowns, advances a statewide hub-and-spoke approach to revitalizing rur…
IA RHTP site updated — 1 new, 2 existing source(s) refreshed
Spreadsheets, data exports, and reference documents — available for download but excluded from the main activity feed.
IA - 2026 - $216 Million in Federal Funding for Iowa Rural Healthcare
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IA - 2026 - Community Services Block Grant
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IA - 2026 - Iowa Congressional Delegation Urges CMS to Expand Rural Health Funding
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IA - 2026 - Iowa PCA Offers Rural Health Technical Assistance Sessions
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Iowa Emergency Medical Services System Standards July 2026
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Notice of Intent to Award Request for Proposal Number: PHTHMRH27002
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Notice of Intent to Award Request for Proposal Number: COMPSCS27025 Marketing and Advertising Services
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IA - 2026 - Senator Grassley Discusses Federal Rural Health Transformation Program Funding
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IA - 2026 - NOTICE OF INTENT TO AWARD TO ALL INTERESTED PARTIES
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IA - 2026 - NOTICE OF INTENT TO AWARD TO ALL INTERESTED PARTIES
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IA - 2026 - Social Services Block Grant
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IA - 2017 - Please accept our apologies. We can't find that page
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IA - 2026 - Notice of Intent to Award (RFP FWBPEHV26018: Iowa Family Support Network)
IA - 2026 - Notice of Intent to Award (COMPADM26002: Health Hub Technical Assistance Provider)
Iowa SUPPORTED EMPLOYMENT FIDELITY REVIEW MANUAL Deborah R. Becker Sarah J. Swanson Sandra L. Reese Gary R. Bond Bethany M. McLeman RHTP 2008 Reference
IA - 2017 - The Community Access and Eligibility's procurement office issues a Request for Proposal (RFP) to find organizations to handle different aspects of healthcare. RFPs require detailed answers in each request, outlined in the…
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IA - 2007 - Keeping Iowa’s Farms in the Family | Governor Kim Reynolds
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IA - 2026 - Vision for Iowa | Governor Kim Reynolds
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IA - 2026 - Welcome to the Governor of the State of Iowa | Governor Kim Reynolds
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IA - 2026 - Family Planning Program | Health & Human Services
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example daily certificate (40.31 KB) .pdf
Child Care Task Force Report
2021 · PDF
Access the HCBS ID Waiver Tiered Rate Fee Schedule (185.17 KB) .pdf
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This leadership update highlights RHTP-funded innovation in rural health, including Iowa's $11M Combat Cancer Health Hub Program, Hudson Headwaters' regional women's health network in New York, and a summary of recent federal awards to states for rural hospital upgrades, EMS training, and expanded specialty care. The $50 billion RHTP investment continues to drive improvements in access, technology, network development, and workforce capacity nationwide. Event schedule: - Rural Health Transformation RoundUp newsletter date - 09/24/2026
Event Schedule
Core Initiatives
Iowa HHS plans to release an RFP in July 2026 for CRC screening EBIs in clinical settings. This notice is informational; requirements and timelines will be finalized in the RFP. Key contacts: Mike Drottz Event schedule: - RFP Release (anticipated) - July 2026 - IowaGrants - Bid Deadline (anticipated) - August 2026 - IowaGrants - Award Contract(s) (anticipated) - September 2026 - IowaGrants
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Contacts
Iowa received over $216 million in federal funding including a $7 million boost for the second year of the Healthy Hometowns Rural Health Transformation Program. The program focuses on expanding rural healthcare access through workforce development and technology upgrades.
Core Initiatives
This competitive RFP from Iowa HHS seeks Hub-and-Spoke oncology networks to receive up to $26.7M over five years for increasing rural access to chemotherapy and specialty cancer care. The program funds network development, telehealth integration, and financial sustainability planning for rural providers. Spoke sites include critical access hospitals, rural clinics, FQHCs, and independent practices, with explicit requirements for collaborative budgeting and service expansion. Key contacts: Jennifer Zepeda [email protected] Event schedule: - RFP Issued - 05/08/2026 - CT - Letter of Intent (Mandatory) - 06/03/2026 - CT - Round 1 Questions Due - 05/20/2026 - 4:00 PM CT - Responses Posted By - 05/27/2026 - CT - Round 2 Questions Due - 06/03/2026 - 4:00 PM CT - Round 2 Responses Posted By - 06/10/2026 - CT - Applications Due - 06/17/2026 - 12:00 PM CT - Applicant’s Oral Presentations (if requested) - August 3, 2026 - CT
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Core Initiatives
Key contacts: Ryan Roovaart reconsiderationrequest@hhs.iowa.gov Event schedule: - Legislation Enacted (House File 972 establishes Healthy Hometowns Program) - 2025-07-01 - America/Chicago - Iowa - Anticipated start/execution of Co-Location Site Lead contracts - 2026-10-31 - America/Chicago - Iowa - Deadline to complete minor renovations and begin services at Co-Location Site - 2027-12-31 - America/Chicago - Iowa - Federal Funding Accountability and Transparency Act (FFATA) Report Due - 2026-10-31 - CST - Insurance Certificate Due - CST - Monthly Progress Report Due (15th working day after month) - CST - Quarterly Report Due - 2027-01-15 - CST - Quarterly Report Due - 2027-04-15 - CST
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Core Initiatives
Core Initiatives
Core Initiatives
The Iowa congressional delegation led by Senator Chuck Grassley sent a letter to the CMS Administrator advocating additional funding for Iowa's Rural Health Transformation Program (RHTP), known as Healthy Hometowns. As part of the Working Families Tax Cuts law, the RHTP invested $209 million in its first year to improve rural healthcare access in Iowa. The letter highlights early successes, such as advanced equipment purchases and expanded services in rural hospitals, and requests continued federal support. Over five years, Iowa is slated to receive at least $100 million annually for rural healthcare transformation.
During a visit to Carroll, Iowa, Senator Charles Grassley addressed questions about the Rural Health Transformation (RHT) Program and its funding. The RHT Program is a $50 billion federal initiative, overseen by CMS, providing states with annual funding from 2026 to 2030 to support rural health transformation. Funds are used to expand telehealth, attract healthcare professionals, and modernize rural facilities. Each year, $5 billion is distributed to states automatically, while the remaining $5 billion goes to select facilities based on rural population and health system characteristics.