Minnesota rural health transformation program

The Centers for Medicare and Medicaid Services awarded the Minnesota Department of Health a $772.362 million cooperative agreement on December 29, 2025, under the Rural Health Transformation Program (CFDA 93.798) to transform rural health care delivery and improve access and outcomes across Minnesota through October 30, 2030.

The award funds five coordinated initiatives aligned with CMS strategic objectives. Minnesota will improve cardiometabolic health outcomes—cardiovascular disease, diabetes, and chronic kidney disease prevention and management—for rural residents. The state will build education pathways and training opportunities to expand the rural healthcare workforce sustainably. Minnesota will expand care access by creating community-based screening and preventive care access points through technology-enabled delivery, mobile care, and community health workers. The state will strengthen provider partnerships to enable expanded services through shared learning, collaborative approaches, and advanced technology. Finally, Minnesota will stabilize rural provider financial health through strategic investments in technology, data infrastructure, and collaborative mechanisms addressing rural providers' unique needs.

Performance occurs across Minnesota. The Rural Health Transformation Program is a one-time application and award with no renewals or extensions. Approved states receive 50 percent of program funding by formula and compete for the remaining 50 percent distributed at the CMS Administrator's discretion. Recipients must maintain grant accounting records for three years after submitting the final Federal Financial Report, or longer if litigation or audit action is pending at that time.

Abstract

MN's plan for rural health transformation adopts a comprehensive, data-driven, coordinated approach that builds on strong partnerships and local priorities and uses emerging technology to improve provider financial sustainability and extend access to health care deeper into trusted rural settings. We envision a vibrant, collaborative, and technology-enabled rural health care system that ensures rural minnesotans have access to the care they need when they need IT, as close to home as possible. To achieve this, we have developed five rhtp goals, aligned with CMS strategic goals: 1. Improve health outcomes for rural minnesotans with or at risk of developing cardiovascular disease, diabetes, and chronic kidney disease (cardiometabolic disease). (CMS goal: make rural america healthy again) 2. Build education pathways and promote training opportunities in rural communities to sustainably expand the healthcare workforce in rural minnesota. (CMS goal: workforce development) 3. Expand health care access in rural communities by creating new access points for community-based screenings, preventive care, and chronic disease management through technology-enabled care delivery, mobile care, and increased use of community-based frontline workers. (CMS goals: sustainable access, make rural america healthy again, tech innovation) 4. Strengthen partnerships between providers to enable delivery of expanded services in rural areas through shared learning, collaborative approaches, and advanced technology interventions. (CMS goals: tech innovation, sustainable access) 5. Strengthen and stabilize rural provider financial health through strategic investments in technology, data infrastructure, and collaborative mechanisms to address unique needs of rural providers. (CMS goals: innovative care, sustainable access, tech innovation) the minnesota department of health is the lead and applicant organization. The total requested dollar amount for the five-year funding period is $1,000,000,000. Subrecipients may include all eligible rural hospitals, federally qualified health centers (FQHCS), community mental health centers (CMHCS), certified community behavioral health centers (CCBHCS) and rural tribal nations. A complete list of potential subrecipients is included in the budget narrative. MN will use rhtp funds to support the five initiatives below consistent with MN's goals, each with a set of potential activities that providers may select to participate in: 1. Community-based preventive care and chronic disease management 2. Recruit and retain talent in rural communities 3. Sustain access to services to keep care closer to home 4. Create regional care models to improve whole person health 5. Invest in technology, infrastructure, and collaboration for financial viability rhtp funds will support these initiatives via a combination of grants to eligible rural providers to support technology and infrastructure improvements to allow providers to practice more efficiently and increase access to screenings and services; competitive grants to increase telehealth technology and use in rural areas, and provide EMS the ability to treat in place; grants to support expansion of clinical training and residencies in rural areas; and technical assistance to support practices to reach financial stability, among other activities.