NCDHHS’ Rural Health Transformation Program aims to improve health in rural communities and make sure high quality care is available for years to come.
With its first year of funding, the state is investing in proven programs while building the local and regional partnerships needed for lasting change. These investments will strengthen the rural health care workforce, improve technology and help communities connect to the care and support they need.
The Rural Health Transformation Program is funded through the U.S. Centers for Medicare & Medicaid Services (CMS) for five years:
Year 1: North Carolina was granted $213 million from CMS. The state has awarded it to local and regional projects, as described on this page. They have until September 2027 to spend it. Read a summary of our Year 1 work.
Year 2: Began October 31, 2026. 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.
Awarded to NC
In The First Year
Rural North Carolinians
Featured Projects
EMS Mobile Integrated Health
$11.2 million, 40 local Emergency Medical Services agencies
Expands opioid treatment by helping EMS agencies start or grow "Mobile Integrated Health" programs. The programs help paramedics provide care for patients in their homes without unnecessary ambulance trips to the emergency department.
ROOTS Hub Leads
$123.5 million, six regions covering all NC counties
Sets up regional networks to coordinate rural health care and direct investments based on local need. Each Hub Lead brings together providers, health departments and community partners in its region.
Six Interconnected Initiatives
The funding is designed to support these six initiatives, plus the cost of running the program. All figures are Year 1 only.
Community-Rooted Care Networks
Local and regional networks that connect medical care, behavioral health care and social services
Prevention and Chronic Disease Management
Better access to primary care, help managing long-term health conditions, maternal health services and nutrition support
Behavioral Health Expansion
More mental health and substance use services, including crisis care and school-based services
Workforce Development
More training and retention programs to prepare and retain people to work in rural health care
Financial Sustainability
New ways to pay health care providers that focus on the quality and results of care
Technology and Innovation
Better use of health information, digital tools and new technology
Administrative costs: Some money pays to run the program, for example staff, operations, monitoring, evaluation and fraud prevention. These expenses are strictly limited to no more than 10% of the total budget. They come out of the six initiative budgets above. In Year 1, these costs are budgeted at a total of $16.5M (7.7% of the total budget).
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.