Andy Van Pelt

The Rural Hospital Transformation Program arrives at a moment of real urgency. Rural hospitals are under strain, workforce shortages persist, and access gaps continue to widen. States are being asked to move quickly—and for good reason. But speed alone will not determine success. RHTP represents something far rarer than a funding opportunity. It is a stewardship moment: a chance for states to shape sustainable, people-centered programs that improve outcomes for patients, providers, and...

Healthcare does not respect state lines—yet much of our infrastructure still assumes it does. Patients in rural and frontier communities routinely travel for hours to access specialty care. EMS agencies cross borders every day to reach the nearest appropriate destination. Health systems operate across multiple states. And during surges—whether driven by respiratory illness, wildfires, extreme heat, or mass-casualty events—the closest available bed is often not in the patient’s home state....

Here we are, December 1st. Over the past several months, I’ve been in conversations with dozens of states as they prepare for the next significant milestone in rural health policy: the CMS Rural Hospital Transformation (RHT) Program . With awards expected to be announced by the end of the year, states are about to enter a rapid and consequential planning process—one that will determine not only how dollars are spent, but whether those investments position rural hospitals for long-term...