Rural Health Transformation Program
North Carolina Rural Health Transformation Program
Improving health in rural communities and making sure high quality care is available for years to come.
The first year of funding has been committed to projects across the state.
The federal government awarded North Carolina over $213 million for the first year of the Rural Health Transformation Program. In Year 1, North Carolina built the statewide and regional structure needed to carry out a five-year transformation, while also leveraging proven programs to get investments and services into rural communities quickly. Read our Year 1 report.
In Year 2, the work will move from planning to delivery. The U.S. Centers for Medicare & Medicaid Services (CMS) notified states of a change in the process for awarding Year 2 program funding. All states will receive an initial $100 million award, with additional funding to follow.
“Every North Carolinian should have access to high-quality health care close to where they live. By investing in the people, services, and technology rural communities need, we can make it easier for families to get the care they need and support rural North Carolina,” said Governor Josh Stein.
Grant Opportunities
News and Updates
Reports and Progress
Why This Matters
More than 3.5 million North Carolinians live in rural communities, giving North Carolina the second largest rural population in the country. Many rural communities face health challenges, including insufficient numbers of health care providers, hospital closures, high rates of chronic health conditions and differences in access to care and health outcomes.
To address these challenges, North Carolina established a multi-pronged approach to coordinate care and community resources, expand access to physical and behavioral health services, strengthen our health care workforce, help rural health care providers become more financially stable and use technology to improve care.
What the Program Funds
We focus on six connected initiatives:
1. Community-Rooted Care Work
Establishing locally governed "NC ROOTS" Hubs that connect medical, behavioral health, and social supports. They make it easier for rural residents to access comprehensive care close to home.
2. Prevention and Chronic Disease Management
Expanding programs for diabetes and hypertension control, cancer screening, maternal health services and nutrition support — including "food as medicine" initiatives.
3. Behavioral Health Expansion
Growing mental health and substance use disorder services through new clinics, mobile crisis teams, school-based programs and integration with primary care.
4. Workforce Development
Training and retaining health care professionals through rural residency programs, incentives and innovative career pathways — creating jobs while addressing provider shortages.
5. Financial Sustainability
Helping rural practices and hospitals transition to value-based payment models that reward keeping people healthy, not just treating illness.
6. Technology and Innovation
Deploying cutting-edge technology, including artificial intelligence to support rural providers, improving health information sharing and ensuring digital literacy for all residents.
A Plan Built With, and For, Rural North Carolina
North Carolina’s Rural Health Transformation Program plan emerged from extensive engagement with more than 420 stakeholders across the state, including rural hospitals, community health centers, local health departments, faith-based organizations, Tribal communities and community members.
The program is designed so that every North Carolinian can see the benefit of this work — from farmers in Robeson County to teachers in Madison County, small business owners in Bertie County and parents in Dare County. It aims to strengthen the health care infrastructure that supports individuals, families and communities across the entire state.
Partnerships Across Sectors
The NC Rural Health Transformation Program Advisory Committee, comprised of more than 40 representatives from across sectors, helps to guide how the program is designed and implemented for our rural communities.
A Federal Investment
The federal government created the Rural Health Transformation Program to help states improve health care in rural communities. States can use the funding to improve technology, strengthen the health care workforce and develop new ways to provide care. In the first year, North Carolina was awarded more than $213 million. The federal program will provide funding for five years, with future funding based in part on state progress and federal funding decisions.
North Carolina is maximizing the funding awarded by the Rural Health Transformation Program. However, the same federal law that created the program, H.R. 1, also reduces federal Medicaid funding to states. North Carolina is projected to lose tens of billions of dollars for health care over the next 10 years as a result.
Questions or feedback?
Email us or contact your regional NC ROOTS Hub Lead.
Stevens Amendment Disclosure: This webpage is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $213,008,356.47 with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.