Massachusetts secured about $162 million in federal dollars Monday to bolster rural health care, part of the first round of funding released in a five-year program.
The Centers for Medicare & Medicaid Services announced it had awarded money to all 50 states through the $50 billion Rural Health Transformation Program, which was created through the One Big Beautiful Bill Act. CMS said $10 billion is available annually from 2026 through 2030, with first-year awards averaging $200 million.
Funding among other New England states was about $154.2 million for Connecticut, $190 million for Maine, $204 million for New Hampshire, $195 million for Vermont and $156.2 million for Rhode Island, according to CMS. Across all states, funding ranged from $147 million in New Jersey to $281 million in Texas.
“More than 60 million Americans living in rural areas have the right to equal access to quality care,” U.S. Health and Human Services Secretary Robert Kennedy, Jr. said. “This historic investment puts local hospitals, clinics, and health workers in control of their communities’ healthcare.”
CMS said the funding will support states as they expand access to care in rural communities, strengthen the rural health care workforce, modernize facilities and technology, and support “innovative” health care models.
Half of the program’s budget will be distributed evenly across all approved states to form a foundation for the future of the program. The other half will be allocated based on factors including state rurality metrics, and proposed actions to improve access and quality of care in rural areas, CMS said.
States must submit progress reports to federal health officials, and will be “reassessed annually to evaluate progress on initiatives and policy commitments,” according to CMS.
Asked how Massachusetts plans to deploy the new funds, a spokesperson for the Executive Office of Health and Human Services said state officials “just received the notice” and are reviewing it.
The One Big Beautiful Bill Act could also double the state’s uninsured rate and cost $3.5 billion annually once all of its health care components take effect, according to Audrey Shelto, president of the Blue Cross Blue Shield Foundation of Massachusetts.
In its 63-page application submitted in November, Massachusetts health and human services officials outlined a funding request of $1 billion over five years and a roadmap for how it would spend federal aid.
There are 160 rural municipalities in Massachusetts, which represent 57% of the state’s land mass. Those communities “face significant barriers to healthcare including higher uninsurance rates, greater reliance on public insurance, rising chronic disease, behavioral health, and substance use disorder burdens,” according to the state’s application.
“Care is often distant, with fewer primary and specialty care access points, fragile EMS, and healthcare systems strained by aging infrastructure,” the application said. “Shrinking access points reflect broader system decline such as rural hospital reductions (11 in 2014 to 6 in 2025), with limited clinics, behavioral health, pharmacies, and long-term care options. Technology and transportation gaps further restrict access.”
Massachusetts proposed seven board initiatives surrounding population health advancement, such as improving clinical infrastructure, increasing coordination, and expanding payment and incentive programs; innovation in rural care models; workforce development, recruitment and retention; supporting community-based prevention activities; EMS service integration; enhancing technology interoperability and connectivity; and facility modernization and re-use.
Within the population health advancement initiative, EOHHS said it would launch a technology platform to connect clinical providers, social services organizations and community-based groups throughout rural areas; develop a data platform to track bed and service availability across rural providers; expand remote patient monitoring programs that are integrated with primary care; implement new home visiting programs; and expand hospital-at-home programs.
To support innovation in rural care models, EOHHS said it would launch mobile health units; expand telehealth use for pharmacy, dental and behavioral health services; establish the “Rural Digital Health Sandbox Program” with the Massachusetts e-health Institute to encourage tech innovations; invest in maternal health care; and expand opioid treatment sites.
On the workforce front, EOHHS proposed launching a rural talent recruitment campaign; expanding statewide rural training networks and pipeline programs; establishing rural nurse practitioner residency programs; supporting “pathways” to housing for clinical and support staff; developing incentive programs for field placements and supervising clinicians in rural communities; and creating a virtual workforce training platform.
To bolster technology, EOHHS discussed creating a local public health electronic record system, as well as providing cybersecurity support and technical assistance to rural providers.
EOHHS also proposed funding “critical capital updates” across rural hospitals, primary care sites and nursing facilities. Without invoking specific hospitals, EOHHS said facilities are “in dire need of investments to support renovations and upgrade equipment to enhance preventive care, increase service offerings, and repurpose underutilized space to both meet community needs and increase revenue for long term fiscal sustainability.”
