Answering the Call for Rural Health Transformation with Digital Health Innovations

By Michael Holcomb, BS and Elizabeth A. Krupinski, PhD on

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The Centers for Medicare & Medicaid Services’ (CMS) “Rural Health Transformation Program (RHTP),” notice of funding opportunity (NOFO), published September 15, 2025, provides States with an historic funding opportunity that seeks to help them transform healthcare delivery for their rural residents.   Each state can separately apply for a portion of $25 billion dollars of “Workload Funding” which is in addition to $25 billion dollars of “Baseline Funding”.   The NOFO includes examples of digital health such as telehealth, AI, and digital therapeutics. These, and other digital health technologies and services can be powerful enablers to improve healthcare access, quality, and outcomes.

The RHTP includes five strategic goals: Make rural America healthy again; Sustainable access; Workforce Development; Innovative care; and Tech innovation.  The “Tech Innovation” strategic goal is to: “Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, strengthen cybersecurity, and invest in emerging technologies.”

Eight example rural healthcare transformation initiatives are provided in the Appendix of the NOFO. The following table highlights some of the digital health aspects integrated into each example initiative:
 

Example RHTP Initiative Selected integrated digital health aspects
Population health infrastructure initiative
  • “…improve rural residents’ health by leveraging technology-enabled prevention, wellness and chronic care management strategies…”
Rural health network initiative
  • “…network services could include…Health information technology…Data analytics…implement AI and other technologies to extend the clinical and/or administrative workforce.”
  • “…non-traditional care models such as…telehealth that can increase access to services for rural patients.”
  • “…networks can establish originating sites for telehealth services in rural maternity care shortage areas that connect patients to obstetricians and specialists for routine and specialist prenatal and postpartum visits to reduce travel time to a clinic or hospital.”
  • “IT systems, software, or data sharing infrastructure, such as health information exchanges or frameworks like The Trusted Exchange Framework and Common Agreement (TEFCA)…”
Rural health regional excellence initiative
  • “This can also include a virtual component with e-consults for providers in rural areas to connect with specialists at regional health systems. Specific examples of collaborative efforts may include establishing telehealth networks for prenatal and postpartum routine and specialty care as well as for maternal health training. These arrangements also facilitate having specialists from regional health systems run simulation training and tele-simulations for providers in rural areas to manage high-acuity, low-occurrence (HALO) events to prepare for emergencies in areas such as obstetrics.”
  • “Use of telementoring for rural providers enabling collaboration and training for managing complex cases and improving quality of services.”
Rural talent recruitment initiative
  • “This training may involve regular virtual and/or in-person sessions as well as access to simulation-based training to address healthcare system deficiencies in rural areas. Provider training should include enhancing telemedicine capabilities which allows the maternal workforce to utilize remote consultation and monitoring technologies effectively.
  • “Use of telementoring for rural providers enabling continuing education, collaboration, and improving quality and scope of services.”
Value-based care initiative
  • “Technical assistance to help rural providers participate in value-based care, including enhancing their ability to correctly code patients’ health status, analyze clinical quality data, implement quality improvement activities, address upstream drivers of health, and utilize appropriate health information technology systems. “
Remote care services initiative
  • “…funds could be used for start-up costs for a tech-enabled care program that allows community health workers to help providers collect essential data on pregnant patients by enabling remote patient monitoring. Patients would be given appropriate durable medical equipment to use as part of remote patient monitoring.”
  • “Development of a standards-based platform that integrates and stores patient health data from remote monitoring devices and existing health records, enabling seamless exchange, real-time monitoring, and actionable patient and provider alerts “
  • “Software infrastructure for digital health solutions like telehealth and patient engagement tools.”
  • “Digital health products for preventing and managing chronic disease…Digital care navigation tools and infrastructure, such as symptom checking, triage, care guidance and scheduling assistance.”
Interoperability infrastructure initiative
  • “Help rural providers invest in technology infrastructure to improve data liquidity and availability between patients, digital health products, and providers.”
  • “Implementation of patient or provider identity verification solutions that enable secure data exchange”
Rural tech catalyst fund initiative
  • “States can encourage the development and adoption of emerging health tech innovation focused on rural populations that improve quality, expand access, and reduce cost of care. This initiative should focus on promoting consumer-facing, technology-driven solutions (including those that support evidence-based, measurable interventions) for prevention and management of chronic diseases, for which traditional government funding sources and private commercial incentives have proven inadequate or insufficient to drive development and innovation.”

With “Innovative Care” and “Tech Innovation” as two of the RHTP’s five strategic goals and the many examples of digital health given in the NOFO, digital health solutions can certainly play core, innovative, and catalyzing roles in the development and sustainment of our future rural healthcare delivery ecosystems. 

These opportunities for rural healthcare innovations are exciting, but time to apply is relatively short.  CMS’ RHTP emphasizes collaboration and consultation with stakeholders. If you need telehealth technical assistance or advice, or are looking for partners with telehealth expertise, consider reaching out to your nearest HRSA-funded Telehealth Resource Center (TRC). For AZ, CO, NM and NV that would be the Southwest Telehealth Resource Center (SWTRC)!
 

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About the Authors

Picture of Michael Holcomb Michael J. Holcomb, BS serves as ATP’s associate director for information technology and as a technology expert for ATP’s federally funded Southwest Telehealth Resource Center (SWTRC).   He serves as an instructor on telemedicine and telehealth cybersecurity in ATP’s and SWTRC’s training programs.  He is a co-investigator on the Agency for Healthcare Research and Quality grant “Reducing Necrotizing Enterocolitis Disparities with a Neonatal Project ECHO.” He served in principal investigator (PI) and co-PI roles on multiple grants while serving as ATP’s interim director from 2023-2025.  He is a past chair of the Technology Special Interest group of the American Telemedicine Association. 
 
Picture of Elizabeth Krupinski Elizabeth Krupinski, Ph.D. is a Professor at Emory University in the Department of Radiology & Imaging Sciences and is Vice-chair of Research. She is Associate Director of Evaluation for the Arizona Telemedicine Program and Director of the SWTRC. She has published extensively in these areas, and has presented at conferences nationally and internationally. She is Past Chair of the SPIE Medical Imaging Conference, Past President of the American Telemedicine Association, President of the Medical Image Perception Society, and Past Chair of the Society for Imaging Informatics in Medicine. She serves on a number of editorial boards for both radiology and telemedicine journals and is the Co-Editor of the Journal of Telemedicine & Telecare.