RHTP Year 1 obligations, as of July 31, 2026
The Rural Health Transformation Program awarded $10 billion to all 50 states for its first budget period. State-reported data from CMS shows how much of it is committed, where it is going, and which states have barely started.
Select a bar to open that state’s summary
Pace by state
Awards are fairly even, from $147M in New Jersey to $281M in Texas. Pace is not. The distribution splits in two rather than forming a bell curve, which says more about how states run the program than about need.
The eight leading states have $1.54B at work. The 22 states under 25% hold $4.57B in awards but have only $0.34B at work.
Stalled starts
$1.64B
Together they report $16.5M put to work, all of it program administration such as staff, contracts and grant management. Several likely have procurements in flight that will surface in the November 30 quarterly report.
| State | At work | Reported |
|---|
Where the dollars go
Totals of state-tagged use categories, about $3.8B of $4.0B. Behavioral health is small as a tagged category but appears in 28 states’ descriptions, funded inside access and workforce lines.
Recurring program models
Number of states naming each model, of 42 with program detail. These show breadth of adoption, not dollars. Emerging: AI in 10 states, cybersecurity in 6.
The biggest single commitments
Half of the top ten are intermediary structures: regional grant models, hub leads and grant programs that will re-grant to providers. The rest are technology and capital bets.
| State | Purpose | Amount |
|---|
Structural patterns
These patterns matter for timing. They shape when provider-level dollars arrive, what states will buy directly, and which payment decisions come next.
The largest awards fund regional hubs and grant programs: Indiana ($120.8M), North Carolina ($75.0M), Kentucky ($41.4M) and California ($39.0M). Provider-level sub-awards are still ahead, through structured application windows.
Iowa committed $39.1M to robotic surgery and $24.4M to MRI. Georgia added $22.0M for robotic surgery, and Pennsylvania $24.4M toward a public osteopathic medical school. States are willing to fund equipment directly.
Georgia put $61.0M into AHEAD readiness and risk mitigation. California set $35.0M for strategically located hospitals, and New Hampshire $30.6M for targeted provider payments.
Reading the data
Use these numbers to understand direction and pace, not as an audit. A state at 100% may still have most of its procurement ahead of it, and a state at 10% may have contracts nearly ready.
State-submitted Year 1 data as of July 31, 2026. CMS refreshes after the November 30 quarterly report.
Obligations include intermediaries and multi-year models, like Indiana’s five-year grants. Provider cash lags.
Some fully obligated states describe uses in broad terms, suggesting budgets set aside rather than signed agreements.
In Hawai’i’s telehealth initiative, several line items exceed their category subtotals. Treat detail as directional.
What this means
The next quarterly report will show whether the long tail is catching up, and whether intermediary dollars are reaching providers.
Sub-grant windows are opening through regional hubs and state grant programs. Readiness for AHEAD, value-based models and data exchange is being funded now.
$6.0B is unobligated, much of it in the 15 states under 10%. Technology, workforce, EMS and behavioral health are the most common lanes.
Pace is now visible state by state. Administration-only reporting will stand out in the next refresh, so clear initiative detail matters.
State lookup
Every state has a summary card: how much of its award is at work, where it ranks, what the money funds and what is still open. Search by name or pick a state on the map.
Original source
This analysis summarizes the RHTP Obligated Funds Report published by the Centers for Medicare & Medicaid Services. It compiles each state’s Year 1 annual report, covering December 29, 2025 to July 31, 2026, and lists funds obligated to state agencies, contractors, community partners, hospitals and other facilities. Figures are state-reported obligations, not cash disbursed. CMS will refresh the report after the November 30, 2026 quarterly submissions.
CMS, published October 8, 2026 · Reporting period Dec 29, 2025 to Jul 31, 2026