Rural Population Health Initiative
Team-based primary care and prevention, better chronic disease management and the state's first Dual-Eligible Special Needs Plan for people on both Medicare and Medicaid.
RHTP state profile · New Hampshire
New Hampshire Rural Health Transformation Program
New Hampshire received $204.0 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 22nd of 50 states. The Governor's Office of New Opportunities & Rural Transformational Health (GO-NORTH) runs the program, which funds five initiatives through regional hubs across the state's seven rural counties and rural parts of Hillsborough and Rockingham, from primary care and prevention to workforce training and facility upgrades.
Year 1 awards, all 50 statesNH: $204.0M
Texas $281.3MNew Jersey $147.3M
$204.0MYear 1 award, 22nd of 50
5Funded initiatives
7 / 10New Hampshire counties are fully rural
GO-NORTHGovernor's Office of New Opportunities & Rural Transformational Health
Spending data in the RHTP Year One Report covers December 29, 2025 to July 31, 2026, the latest CMS reporting window.
At a glance
New Hampshire's program at a glance
The award is fixed for the year. Spending moves every quarter, so New Hampshire's section of the RHTP Year One Report tracks how much was put to work, and with whom, through July 31, 2026. It updates after each CMS data release.
Year 1 award$204,016,550, 22nd of 50 states
Run byGovernor's Office of New Opportunities & Rural Transformational Health
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives5
Fully rural counties7 of 10
Spending data through July 31, 2026New Hampshire's section of the Year One Report →Initiatives
What does New Hampshire's RHTP fund?
New Hampshire's RHTP, titled "Granite Strong. Future Ready.", funds five initiatives across prevention, access, workforce, technology and finances. GO-NORTH routes most of the money through five hubs, and every hub funding opportunity maps to one of these five.
Rural Healthcare Access Initiative
Care coordination, primary, behavioral and oral health care, specialty telehealth at rural hospitals, certified community behavioral health centers statewide and more long-term services and supports.
Rural Workforce Recruitment and Retention Initiative
Health career pathways from high school through graduate school, rural simulation labs and a family medicine residency in Coos County.
Rural Health Technology Initiative
Digital health infrastructure, telehealth, AI tools, data sharing and cybersecurity for rural providers.
Rural Financial Solvency Initiative
Value-based payment models, simpler financial operations and support for safety-net providers.
Recipients by initiative are in New Hampshire's section of the RHTP Year One Report.
Source documents
New Hampshire's full plan is public
The approved plan has more detail than any summary: goals, partners, metrics and timelines for each initiative. Read it before responding to a New Hampshire funding opportunity.
PDFGO-NORTHNew Hampshire RHT Program Project NarrativeThe full plan, "Granite Strong. Future Ready.", including all five initiatives and New Hampshire's policy commitments.PDFGO-NORTHNew Hampshire RHT Application SummaryA short overview of the plan.PDFGO-NORTHGO-NORTH Year 1 Progress Report: Executive SummaryGO-NORTH's October 2026 summary of Year 1 policy actions, uses of funds and recipients.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Fully rural county (7)Other counties (3)
Eligibility
Which New Hampshire counties are eligible for RHTP funding?
Seven of New Hampshire's 10 counties are fully rural under the federal Office of Rural Health Policy definition: Belknap, Carroll, Cheshire, Coos, Grafton, Merrimack and Sullivan, and some census tracts in Hillsborough and Rockingham counties also count as rural. GO-NORTH's planning grants accept projects in these HRSA-defined rural areas or from facilities that meet the program's rural health facility definition. Each funding opportunity states its own geographic requirements.
View HRSA's list of rural counties and tracts →How to apply
How can New Hampshire providers apply for RHTP funding?
New Hampshire providers apply through funding opportunities from GO-NORTH and its five hubs: the Foundation for Healthy Communities, the Community Development Finance Authority, the New Hampshire Community Behavioral Health Association, the University System of New Hampshire and the Community College System of New Hampshire. The Foundation for Healthy Communities has open rounds for hospitals and primary care, and GO-NORTH accepts planning grant applications on a rolling basis. Providers and vendors don't apply to CMS directly.
- Match the work to an initiative.Funding only goes to work that fits one of the five, and each hub funds a set of them.
- Watch the hubs.Check GO-NORTH's Funding Opportunities page and the Foundation for Healthy Communities' RHTP page for new RFAs and RFPs.
- Start with a planning grant.Rural municipalities, county health facilities, FQHCs, Critical Access Hospitals and rural dental providers can apply for up to $50,000, on a rolling basis until funds run out.
- Plan for federal rules.Grant recipients follow federal grant, reporting and audit rules. A Single Audit applies at $1 million or more in federal spending a year. Hub sub-grants and contracts also go to the Executive Council for approval.
- Ask GO-NORTH directly.Email info@go-north.nh.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every New Hampshire recipient.
Grants and contracts carry different obligations
A subaward makes your organization a subrecipient that carries out part of the program, with federal reporting and audit requirements. A contract pays for goods or services, with lighter requirements.
New rounds follow CMS budget approval
States can't post funding opportunities until CMS approves their budget, so windows can open months into a budget period.
Workforce incentives need a rural commitment
Recruitment and retention payments require clinicians to commit to serving rural communities for at least five years.
Recipients must disclose the federal funding
Under the Stevens Amendment, websites, social posts and other public materials about a funded project must name the federal funding.
Allowable costs
What can New Hampshire's RHTP funding pay for?
New Hampshire's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to New Hampshire's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $40.8M
Provider payments15% of award
About $30.6M
Administrative costs10% of award
About $20.4M
Rural Tech Catalyst Fund10% or $20M, whichever is less
$20.0M
Replacing an existing EMR system5% of award
About $10.2M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to New Hampshire's plan. They can't raise rates for services providers already bill.
Capital funds go to existing facilities: renovations, accessibility upgrades, HVAC and like-for-like equipment replacement.
Off limits
- New construction, demolition and major expansions
- Cosmetic work such as painting, carpet or decor
- Clinician salaries at facilities that use non-compete clauses
- Home broadband installation and service
- Costs already covered by other federal or state funding
Policy commitments
New Hampshire's policy commitments carry deadlines
New Hampshire committed to seven policy actions in its application, according to CMS. One is done. CMS can reduce or recover funding if the rest slip.
PA licensure compact
Join the Physician Assistant Licensure Compact
HB 1772 signed July 15, 2026EMS licensure compact
Join the EMS Personnel Licensure Interstate Compact
Not yet a member as of October 2026SNAP food restriction waiver
Seek a USDA waiver limiting non-nutritious SNAP purchases
HB 1773 failed in the House in March 2026Pharmacist scope of practice
Let pharmacists prescribe and order lab tests on their own
HB 1735 updated pharmacy law in July 2026Dental hygienist scope of practice
Let dental hygienists bill independently for dental services
Nutrition education for physicians
Require nutrition continuing medical education
Presidential Fitness Test
Bring back the Presidential Fitness Test in schools
Education Department to update school requirementsNew Hampshire already belongs to the physician, nurse and psychology licensure compacts.
Years 2 to 5
$40B
Future awards depend on progress
Year 1 is not a guaranteed annual amount. CMS plans up to $40 billion more nationwide through 2030 and rescores every state each year on progress, data and policy actions.
Unobligated money leaves the state
Funds not obligated by the end of a budget period can't be obligated later and are redistributed to other states.
Funds can be clawed back
CMS can withhold, reduce or recover money for unallowable costs, unapproved plan changes or missed policy commitments. States get 90 days to fix a violation, and most decisions can't be appealed.
Oversight is growing
CMS's Office of Rural Health Transformation plans site visits in all 50 states in 2026. Audits start in 2027.
Method
Reading New Hampshire's spending data
Use the numbers in New Hampshire's section of the RHTP Year One Report to understand direction and pace, not as an audit.
Put to work is not paid out
Obligated money is signed to a contract or grant. Cash reaches recipients later.
Through July 31, 2026 only
The data covers December 29, 2025 to July 31, 2026, as New Hampshire reported it to CMS. Commitments made after July 31, 2026 are not counted yet.
Recipients sit inside line items
The CMS report has no recipient column. Search New Hampshire's line item descriptions by name.
Quarterly refresh
CMS updates the data after each quarterly state report, starting with the November 30, 2026 filing.
Announcements
Major New Hampshire announcements
GO-NORTH and the Foundation for Healthy Communities announce $11 million for rural EMS equipment, training and five new mobile integrated health programs.
Gov. Kelly Ayotte signs HB 1772, making New Hampshire the 28th state in the PA Licensure Compact.
CMS approves New Hampshire's RHTP budget, one of the first states approved.
GO-NORTH lays out about $773 million in five-year hub plans, led by $283 million for the Foundation for Healthy Communities and $223.2 million for the Community Development Finance Authority.
The Executive Council approves the first four hub contracts, about $133 million, after tabling them on March 4.
CMS awards New Hampshire $204.0 million for Year 1.
Awards announced after July 31, 2026 are not in the CMS spending data yet. They will appear after the next CMS refresh.
Timeline
Key dates
- Dec 29, 2025Year 1 award; Budget Period 1 begins
- Mar 16, 2026Executive Council approves the first four hub contracts
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Oct 30, 2026Budget Period 1 ends
- Nov 12, 2026Priority deadline for the Foundation for Healthy Communities hospital RFA
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Sep 30, 2027Deadline to spend Year 1 funds
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
The Foundation for Healthy Communities has an open RFA for Critical Access and acute care hospitals, with a November 12, 2026 priority deadline, and the Community Development Finance Authority funds capital work at rural health facilities, including county nursing homes. Rural EMS is getting $11 million for equipment, training and mobile integrated health.
For partners and vendors
New Hampshire routes most of its money through five hubs, so partnering with a hub is the main route in. The Foundation for Healthy Communities is recruiting consultants for its Transformation Technical Assistance Center, and the Community Behavioral Health Association has sought IT vendors for mental health centers. Hub sub-grants and contracts need Executive Council approval, which adds time.
For applicants and grantees
Build tracking for the metrics New Hampshire reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed New Hampshire's annual rescoring. Hub administrative costs are capped at 10%, and Year 1 funds must be spent by September 30, 2027.
FAQ
New Hampshire RHTP FAQs
Who runs New Hampshire's Rural Health Transformation Program?
The Governor's Office of New Opportunities & Rural Transformational Health (GO-NORTH) runs New Hampshire's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS) awarded to the New Hampshire Department of Health and Human Services. GO-NORTH manages the state's plan, oversees five funding hubs and answers questions at info@go-north.nh.gov. The program is New Hampshire's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did New Hampshire receive?
New Hampshire received $204,016,550 for Year 1 of the Rural Health Transformation Program, 22nd of 50 states. Every state got $100 million in baseline funding, and the rest of New Hampshire's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on New Hampshire's progress.
Can New Hampshire RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of New Hampshire's award each year, about $40.8 million in Year 1, can go to work on existing facilities, such as renovations, accessibility upgrades, HVAC replacement and like-for-like equipment replacement.
Can New Hampshire providers use RHTP funding to pay for patient care?
Only for care that insurance doesn't already pay for. Provider payments can cover nonreimbursed services, quality bonuses and outcome-based payments tied to New Hampshire's plan, up to 15% of the award each year, about $30.6 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how New Hampshire is spending its RHTP funding?
The RHTP Year One Report tracks how much of New Hampshire's award was put to work through July 31, 2026, by initiative and recipient, using state-reported data from CMS, and is updated after each CMS data release. GO-NORTH also posts its own list of approved contracts and awards, which includes awards made after July 31, such as $11 million for rural EMS in October 2026.
The Alliance
RHT Alliance members serving New Hampshire
These RHT Alliance members serve New Hampshire providers, with support that spans virtual nursing, virtual care, virtual dental care, remote monitoring, health data, diagnostics, patient education and grant writing.
Azalea HealthCloud EHR and billing with AI-assisted charting for rural hospitals and clinics.
CorstrataTelehealth access to board-certified wound, ostomy and continence nurses.
Equum MedicalTelehealth-enabled physician coverage across specialties.
Health Recovery SolutionsRemote patient monitoring and care management at home.
InterSystemsHealth data platforms and interoperability.
Medical Equipment SourceDigital pathology, mobile labs and lab equipment services.
Rural Health Transformation Funding NetworkGrant writing support for RHTP funding opportunities.
Self Care DecisionsEvidence-based triage that directs patients to the right level of care.
Solid StartsInfant feeding guidance and education for families, built by pediatric feeding specialists.
Teledentistry.com24/7 virtual dental evaluations and emergency triage.
VitalChatVirtual nursing and continuous audio and video care across hospitals.
WebMD IgniteMedically reviewed patient education and outreach, including its HEART rural program.Follow New Hampshire's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.