Rural Health Transformation Program

The Governor’s Office invites community stakeholders to provide input on how Delaware should direct investments from the Rural Health Transformation Program. The Governor’s office seeks ideas, priorities, and organizational capabilities to guide investment in rural health improvement efforts.

Important: This call for ideas is not a funding application, and responding does not guarantee funding. The State may choose to fund projects identified outside of this process. Respondents are encouraged to propose both specific projects they could implement and broader priorities they view as critical to advancing rural health—even if they do not intend to carry them out directly.

The Governor’s Office and relevant state agencies will review submissions. Insights will inform Delaware’s Transformation Plan to CMS and guide future investments from the Rural Health Transformation Fund. The deadline to submit is 5:00 p.m. ET, September 19, 2025.

Background: The Rural Health Transformation Program provides $10 billion annually from FY 2026 through FY 2030 (totaling $50 billion) to states with approved applications. This RFI is intended to help shape how the State of Delaware aligns these priorities within its Transformation Plan to CMS.

Distribution of Funds:
- 50% of funds will be allocated equally among all states with approved applications.
- From this pool of equally divided funds, Delaware could receive as much as $500 million over a five-year period.
- The remaining 50% will be distributed based on the Centers for Medicare & Medicaid Services (CMS)-designated criteria, including:
  - The share of the state’s population in rural census tracts.
  - The proportion of rural health facilities.
  - The situation of hospitals.
  - Other factors the CMS Administrator deems relevant.

Eligible Uses: States must fund at least three of the following types of activities:
- Evidence-based interventions to improve prevention and chronic disease management
- Payments to health care providers for specified services
- Consumer-facing, technology-driven solutions for prevention and chronic disease management
- Training and technical assistance for use of technology (e.g., remote monitoring, AI, robotics)
- Recruiting and retaining clinical workforce in rural areas with a minimum five-year service commitment
- IT upgrades—cybersecurity, efficiency improvements, better outcomes
- Supporting communities in “right-sizing” their health care delivery systems
- Access to opioid use disorder, substance use, and mental health services
- Innovative care models including value-based care and alternative payment mechanisms
- Other CMS-approved efforts to promote sustainable, high-quality rural health care services