HRP: Service Line Expansion and Co-Location
Competitive grants to add primary, behavioral, specialty and perinatal services inside existing rural hospitals and clinics.
RHTP state profile · Tennessee
Tennessee Rural Health Transformation Program
Tennessee received $206.9 million in Year 1 of the $50 billion federal Rural Health Transformation Program, 19th of 50 states. The Tennessee Department of Health (TDH) runs the program, which funds 17 initiatives across the 89 of Tennessee's 95 counties outside its six metro counties, from rural hospital service lines and maternal care to EMS, health technology and workforce.
Year 1 awards, all 50 statesTN: $206.9M
Texas $281.3MNew Jersey $147.3M
$206.9MYear 1 award, 19th of 50
17Funded initiatives
89 / 95Tennessee counties are rural
TDHTennessee Department of 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
Tennessee's program at a glance
The award is fixed for the year. Spending moves every quarter, so Tennessee'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$206,888,882, 19th of 50 states
Run byTennessee Department of Health
Budget Period 1December 29, 2025 to October 30, 2026
Initiatives17
Rural counties89 of 95
Spending data through July 31, 2026Tennessee's section of the Year One Report →Initiatives
What does Tennessee's RHTP fund?
Tennessee's RHTP funds 17 initiatives across five focus areas: rural health care access, maternal and child health, Make Rural Tennessee Healthy Again, technology and workforce. Five of them run as competitive grant lines under TDH's Healthcare Resiliency Program (HRP).
Last Mile Teams
Expands rural EMS and community paramedicine, mobile behavioral health, regional health care coalitions and maternal care coordination.
Optimizing Rural Health Care
Expands the safety net for uninsured adults and adds navigation teams and direct services at rural local health departments.
Memory Care Assessment Network
A hub-and-spoke network that links rural memory assessment centers to specialists for dementia diagnosis and treatment.
Rural Capacity Building
Rural health leadership training, behavioral health workers placed in health departments and emergency departments, and community health worker programs.
Dental Pilot
Extends the Rural Dental Pilot to recruit dental staff, open new dental access points and expand preventive oral health care.
HRP: Maternal and Child Health
Grants to upgrade rural birthing facilities, strengthen perinatal care and add maternal health technology.
Value-Based Payment: Maternal, Hospitals, Dental
Builds value-based payment models for obstetric practices, rural hospitals and dental practices.
HRP: Make Rural Tennessee Healthy Again (MaRTHA)
Competitive grants for community prevention, mobile care, telehealth and school health nursing.
Rural Health Improvement Grants
Local grants for nutrition, active living, healthy built environments and policy, systems and environmental change.
HRP: Rural Non-Emergency Transportation (RNET)
Grants and a statewide coordination platform to get rural patients to appointments.
HRP: Health-Tech
Grants for rural clinic technology, interoperability, cybersecurity and digital workflow tools.
Statewide Health Information Exchange (HIE)
Builds Tennessee's first statewide health information exchange connecting rural providers, hospitals and payers.
TN Community Compass
Expands a closed-loop referral platform that connects people to community organizations for social needs.
Rural Health Innovation Catalyst
A UT Health Science Center hub offering planning grants and technical assistance for rural health technology.
Statewide eConsult Platform
Gives rural providers fast specialist consultations for safety-net patients.
Comprehensive Health Workforce Pipeline
More rural residencies, recruitment incentives, early career exposure and behavioral health training.
Recipients by initiative are in Tennessee's section of the RHTP Year One Report.
Source documents
Tennessee'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 Tennessee funding opportunity.
PDFTDHTennessee RHT Program ApplicationThe full plan from TDH, including all 17 initiatives and Tennessee's policy commitments.PDFTDHTennessee RHTP Community Kickoff PresentationTDH's March 31, 2026 overview of funding lines, five-year amounts, eligible counties and timelines.PDFCMSCMS 50-State SpotlightsCMS's short profile of each state's program, including Tennessee's.PDFCMSCMS State Project AbstractsEach state's own summary, side by side.
Rural county (89)Metro counties (6)
Eligibility
Which Tennessee counties are eligible for RHTP funding?
Tennessee's program treats 89 of the state's 95 counties as rural, every county except the six metro counties of Davidson, Hamilton, Knox, Madison, Shelby and Sullivan. About 2.3 million Tennesseans, one in three residents, live in rural areas. Some funding lines also use HRSA rural designations, so each opportunity states its own geographic rules.
How to apply
How can Tennessee providers apply for RHTP funding?
Tennessee providers apply for RHTP grants through TDH's online Partner Portal, and TDH buys program services through state requests for proposals. The nine Year 1 competitive grant rounds ran from May to August 2026 and have closed. 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 17.
- Create a Partner Portal account.TDH takes grant applications through its RHTP Partner Portal, and applicants must be registered with the State of Tennessee.
- Watch for new rounds.Sign up for TDH funding notices, and check the TDH procurement page for RHTP grants and requests for proposals.
- Register in SAM.gov.It is standard for federally funded grants and contracts. Vendors also register in Tennessee's Edison Supplier Portal before a contract award.
- Plan for federal rules.Subawards are paid by reimbursement, so recipients pay costs first. Grant recipients follow federal grant, reporting and audit rules, and a Single Audit applies at $1 million or more in federal spending a year.
- Ask TDH directly.Email RuralHealth@tn.gov.
Federal terms
Four rules that shape every award
Federal terms follow the money down to every Tennessee 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 Tennessee's RHTP funding pay for?
Tennessee's RHTP funding can pay for work on existing facilities, uncovered care, technology and administration, within federal caps on each use. Applied to Tennessee's Year 1 award, the maximums are:
Capital and infrastructure20% of award
About $41.4M
Provider payments15% of award
About $31.0M
Administrative costs10% of award
About $20.7M
Rural Tech Catalyst Fund10% or $20M, whichever is less
$20.0M
Replacing an existing EMR system5% of award
About $10.3M
Provider payments and capital
Provider payments cover services insurance doesn't pay for, quality bonuses and outcome-based payments tied to Tennessee'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
Tennessee's policy commitments carry deadlines
Tennessee committed to nine policy actions in its application. Two are done. CMS can reduce or recover funding if the rest slip.
Presidential Fitness Test
Pass a law requiring schools to bring back the Presidential Fitness Test
Public Chapter 598 (HB 1466), effective March 18, 2026Nutrition education for physicians
Pass a law making nutrition part of physicians' continuing medical education
SB 2239 signed in 2026; the requirement starts January 1, 2028SNAP sugary food restriction
Obtain a USDA waiver to exclude soda, energy drinks and candy from SNAP purchases
USDA approved the waiver December 10, 2025, but a federal court vacated the approval June 22, 2026Remote patient monitoring
Adopt a policy documenting Medicaid coverage of remote patient monitoring, if needed
TennCare already pays for remote monitoring and store-and-forward careCertificate of need
Pass a law eliminating certificate of need across facility categories
SB 1369, signed May 5, 2026, ends it only for hospitals, satellite emergency departments and cardiac catheterization, from 2028 to 2030Nurse practitioner scope
Pass a law giving nurse practitioners full practice authority
SB 2245 / HB 2554 stalled in the 2026 sessionPhysician assistant scope
Pass a law giving physician assistants optimal team practice
SB 2243 / HB 2555 stalled in the 2026 sessionPharmacist prescribing
Pass a law giving pharmacists full prescribing authority
SB 2242 / HB 2557, a test-and-treat bill, stalled in the 2026 sessionDental hygienist scope
Pass a law giving dental hygienists unrestricted scope of practice
SB 2244 failed. A separate law, Public Chapter 1107, expands hygienist duties under dentist supervision from January 1, 2027Tennessee already belongs to the physician, nurse, EMS, psychology and physician assistant 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 Tennessee's spending data
Use the numbers in Tennessee'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 Tennessee 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 Tennessee'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 Tennessee announcements
TDH announces the first 53 RHTP grants, all Healthy Active Rural Tennessee projects for nutrition, fitness and community supports, across 44 counties.
TennCare posts a Request for Applications for its Community Health Worker Infrastructure Project, with priority for organizations serving rural communities.
TDH opens the Rural Healthcare Access Modernization Program (RAMP), $104.4 million in state TennCare Shared Savings that complements RHTP with capital and primary care grants.
TDH opens the first of nine Year 1 competitive grant rounds, which run through August 10, 2026.
Governor Lee signs SB 1369, ending certificate of need for acute care hospitals, satellite emergency departments and cardiac catheterization in stages from 2028 to 2030.
TDH holds a statewide kickoff session on RHTP funding lines and eligibility.
The legislature's Joint Ways and Means Committee votes to accept about $207 million in Year 1 RHTP funding.
CMS awards Tennessee $206.9 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
- Jan 14, 2026Joint Ways and Means Committee accepts Year 1 funding
- Mar 18, 2026Presidential Fitness Test law takes effect
- May 15, 2026First Year 1 competitive grant round opens
- Jul 31, 2026End of the first CMS reporting window; Year One Report spending data runs through this date
- Aug 10, 2026Last Year 1 competitive grant round closes
- Sep 3, 2026First 53 RHTP grants announced
- Oct 30, 2026Budget Period 1 ends
- Nov 30, 2026Quarterly reports due; CMS refreshes funding data
- Dec 31, 2026Remote patient monitoring policy deadline
- Jan 1, 2027Certificate of need and scope of practice deadlines
- Sep 30, 2027Deadline to spend Year 1 funds
- Jan 1, 2028Nutrition continuing education requirement for physicians begins
- 2030Final year of the five-year program
Implications
What this means
For rural hospitals
Service line expansion, maternal and child health, and health technology carry the largest planned five-year amounts in TDH's Healthcare Resiliency Program. RHTP can't pay for new construction, but RAMP, a separate $104.4 million state program, funds rural facility modernization and primary care sites and is taking applications now.
For partners and vendors
TDH buys RHTP services through state requests for proposals, including management consulting, marketing, a maternal care call center, a pregnancy education app and provider-to-provider eConsults. Register in the Edison Supplier Portal and join the TDH procurement mailing list. Health technology, maternal care, EMS and workforce are the most active lanes.
For applicants and grantees
Build tracking for the measures Tennessee reports to CMS before an award lands. Subrecipients can't opt out of reporting, and their results feed Tennessee's annual rescoring. Subawards are paid by reimbursement, so plan cash flow, and spend Year 1 funds by September 30, 2027.
FAQ
Tennessee RHTP FAQs
Who runs Tennessee's Rural Health Transformation Program?
The Tennessee Department of Health (TDH) runs Tennessee's Rural Health Transformation Program, using federal funding from the Centers for Medicare & Medicaid Services (CMS). TDH manages the state's plan, posts funding opportunities and answers questions at RuralHealth@tn.gov. TennCare runs some parts, such as the Community Health Worker Infrastructure Project. The program is Tennessee's share of the $50 billion federal Rural Health Transformation Program.
How much RHTP funding did Tennessee receive?
Tennessee received $206,888,882 for Year 1 of the Rural Health Transformation Program, 19th of 50 states. Every state got $100 million in baseline funding, and the rest of Tennessee's award was based on its rural needs, its policy commitments and the strength of its plan. Later years depend on Tennessee's progress.
Can Tennessee RHTP funding pay for construction?
No. RHTP funds can't pay for new construction, demolition or major expansions. Up to 20% of Tennessee's award each year, about $41.4 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 Tennessee 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 Tennessee's plan, up to 15% of the award each year, about $31.0 million in Year 1. They can't raise rates for services providers already bill.
Where can I see how Tennessee is spending its RHTP funding?
The RHTP Year One Report tracks how much of Tennessee'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. Awards announced after July 31, such as the first 53 Healthy Active Rural Tennessee grants in September 2026, will appear after the next CMS refresh.
The Alliance
RHT Alliance members serving Tennessee
These RHT Alliance members serve Tennessee providers, with support that spans EHR and billing, 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 Tennessee's money as it moves
The RHTP Year One Report tracks obligations, initiatives and recipients for all 50 states after each CMS data release.