Rural Health Transformation funding in North Carolina

First-year award: $213M
Reported put to work, as of Jul 31, 2026: $168M; 79% of the award; This figure stops at Jul 31, 2026. CMS has announced more for North Carolina since. See below.
Application rounds open today: 1

Build a plan for North Carolina →Official state program ↗

Rounds to look at

Dec 7, 2026
Open
Readiness intake and full application
Rural Health Innovation Fund
Full application by Dec 7, 2026, 11:59 p.m.
$20M. Approximately annual fund allocation, not per-applicant award
Only for entities that completed the readiness intake, which closed Oct 31, 2026. Check the state page.
Read the official notice ↗Checked Nov 7, 2026.
No date posted
Upcoming
Region 3 ROOTS Hub grants (Vaya)
NC ROOTS Hubs
Vaya leads the Region 3 ROOTS Hub for the state program. It says grant opportunities will open in fall 2026; no date is posted.
Read the official notice ↗Checked Nov 7, 2026.

What the state review found, as of Nov 7, 2026

Rural Health Innovation Fund intake closed October 31; entities that completed it have until December 7 at 11:59 p.m. to submit the full application. The Region 3 ROOTS Hub, led by Vaya, says its grants open in fall 2026.

Where North Carolina's money has gone so far

As North Carolina reported it to CMS through Jul 31, 2026. These are commitments to agencies, contractors and partners, not a measure of what has reached patients.

Fostering collaboration$78.5M
Workforce$34.8M
IT advances$27.4M
Prevention and chronic disease$10.2M
Behavioral health$10M
Innovative care$3.5M
Program administration$3.3M

Read the detail with care. The line items below differ from the headline by $8,287,053. The figures are shown as CMS printed them.

Initiative detail

Build Rural Community Care Network "Hubs"$78M

$75MNorth Carolina Rural Health Transformation (NCRHT) Program Hub Lead to establish regional governance and action planning. Investments in appropriate care based on action plan. (Fostering collaboration)
$3MConducting needs assessment. (Prevention and chronic disease)

Create Models & Capacity for Expanded Primary Care, Prevention, and Chronic Disease$7.2M

$7.2MPreventing chronic disease based on regional needs and action plan. (Prevention and chronic disease)
$25KMinority Diabetes Prevention Program (MDPP) Awardee. (Prevention and chronic disease)

Expand and Integrate Behavioral Health and Substance Use Disorder Services$10M

$1.3MImplementation of the NCRHT Program's Certified Community Behavioral Health Clinics (CCBHC) Project which is designed to improve access to community-based mental health and substance use disorder treatment and support, including 24/7 crisis services, to anyone in their service area who needs it, regardless of their age, ability to pay, or place of residence, particularly in rural and underserved communities. (Behavioral health)
$1.5MImplementation of the NCRHT Program's Expansion of First Episode Psychosis (FEP) Services Project which involves early intervention services for youth and young adults ages 15-30 who are experiencing the emergence of a psychotic disorder. (Behavioral health)
$750KImplementation of the NCRHT Program's Opioid Treatment Program (OTP) Project which is designed to expand access to evidence-based treatment for individuals with opioid use disorder (OUD), particularly in rural and underserved communities. (Behavioral health)

Build a Robust & Resilient Workforce & Innovative Care Team Models for Rural Communities$34.8M

$34.8MRegional workforce needs based on regional needs and action plan. (Workforce)

Ensure Fiscal Sustainability of Rural Health Providers Through Innovative Financial Models$3.9M

$3.5MHospital feasibility studies and capacity building for Primary Care Pilot. (Innovative care)
$400KStrategy & design related to value-based payment (VBP) model, performance measures, member attribution model and stakeholder feedback support. (Program administration)

Modernize Rural Care Delivery Through Digital Forward Solutions$27.4M

$5.5MOnboarding eligible rural providers to the Health Information Exchange (HIE) Network in a manner that will maximize health care savings and efficiencies to the State as well as optimize positive impacts on health outcomes for rural communities. Further, the NC HIE Authority will enhance and customize its services--and the training and technical assistance needed to support those services--to meet the expressed needs of rural providers. (IT advances)
$20MThe Rural Health Innovation Fund (RHIF) will serve as a catalytic investment to help rural health providers modernize operations and health information technology (IT) infrastructure. The fund will enable providers to assess existing data systems, identify technology needs, evaluate vendors, and manage procurement and implementation. $1,870,386.45for Digital Health Literacy Partnership. (IT advances)

Program operations$6.4M

$3.5MDelivers technical assistance and peer learning across Rural Organizations Orchestrating Transformation for Sustainability (ROOTS) Hubs and partners. (Fostering collaboration)
$1MDesigning an evaluation plan and evaluate NCRHTP activities and investments across six initiatives. (Program administration)
$265KMicrosoft (MS) Power Platform implementation support for sub-recipient and vendor management solution. (Program administration)
$1.6MNC Department of Health and Human Services (DHHS) personnel, fringe, travel supply costs, and cost allocation as detailed in most recent projected budget. (Program administration)

Source: RHTP Obligated Funds Report ↗

What CMS has announced for North Carolina

Funding is one part of the job

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Who built this

Jeff Paul

Founder & Principal, JP Healthcare Advisors

During eight years at Cerner, I worked across 170+ healthcare technology deployments. My deepest specialization was CommunityWorks: more than 90 community, rural, district, and critical-access hospitals in 34 states, including 62 critical-access hospitals.

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