Using APCDs to Strengthen Funding Applications Under the Rural Health Transformation Program

October 2025 - This post provides a brief overview of the application process for the new federal Rural Health Transformation (RHT) Program and how all-payer claims databases (APCDs) can serve as valuable resources when applying for funding under this new opportunity’s rapidly approaching application deadline of November 5, 2025.

Details about the RHT Program Funding

The Rural Health Transformation Program was authorized by Congress as part of the massive spending bill H.R. 1 (Public Law 119-21), which was passed in July 2025. H.R. 1 includes a series of measures bundled together under the bill’s Chapter 4 (“Protecting Rural Hospitals and Providers”). This chapter’s measures include the RHT Program (formally, Section 71401), which has an allocation of $50 billion in funding over the next five fiscal years.

All 50 states are eligible to apply and receive a portion of the $50 billion in RHT Program funding, with $10 billion available annually beginning in fiscal year 2026, which started on October 1, 2025, and continues through September 2026.

Under the program, 50% of funding is to be distributed among all approved states. The other 50% is to be allocated by the U.S. Centers for Medicare & Medicaid Services (CMS) to a subset of states based on a variety of factors, including rural population, the proportion of rural health facilities in the state, the situation of certain hospitals in the state, and other factors specified by CMS in the notice of funding opportunity (NOFO), CMS-RHT-26-001. Awards will be decided by December 31, 2025.

Strengthen Your Application with Your APCD

The RHT Program’s NOFO requires states to provide multiple plans in support of their application. Key among these are the application’s Rural Health Transformation Plan and the Metrics & Evaluation Plan. States with active all-payer claims databases (APCDs) have a vital resource to inform and strengthen their applications in these and other areas.

The application’s Rural Health Transformation Plan asks states to detail their vision, goals, and strategies for transforming rural health across a series of key elements, including improving access, improving outcomes, fostering partnerships, leveraging data-driven solutions, and more. State APCDs can play a key role in many of these areas, especially in demonstrating data-driven solutions – for example, providing data to build dashboards that illustrate the prevalence of medical conditions and prescription drug use, healthcare utilization and costs, and healthcare quality measures of rural populations. These measures can be used to drive quality improvement by highlighting gaps in care and the need for specialized rural outreach programs.

The RHT Program’s funding application also requires a Metrics & Evaluation Plan that must include details related to how the state will make a quantifiable difference at the county or community level. State APCDs can be used to provide many of the measures (e.g., access, quality and health outcomes, workforce metrics, technology use) stratified by relevant geographies. Most APCDs include state residents enrolled in Medicare, Medicaid, and the majority of commercial plans. Further, state APCDs enable the tracking of members as they change insurers and insurance coverage, which is particularly important as states unwind Medicaid continuous enrollment related to the COVID‑19 pandemic.

How Can Onpoint Help? A Brief Q&A with Kate Ahrens.

Wondering how Onpoint can support your application and planning for the Rural Health Transformation Program? We sat down with Onpoint principal health data analyst Kate Ahrens, PhD, MPH, to talk through some top-of-mind questions:

• How do you see APCDs playing a role in state applications for RHT Program funding?
  There are some great opportunities for states in this area. States can leverage their APCD to produce the quantifiable metrics required under key program areas like rural health service quality improvement initiatives. They also can leverage the funding opportunity to establish or improve their APCDs for increased utility by analysts working in these areas.

• For clients granted funding, how could Onpoint support their work?
  The states could use their APCD to produce the monitoring and evaluation metrics they need to report back to CMS on their performance. If helpful, Onpoint’s team could support their analyses, generate reporting, and deliver dashboards focused on key areas of rural health to support their work.

• What is the quickest way for states to reach Onpoint for support or questions?
  With the rapidly approaching November 5 application deadline, clients can get quick answers and support by simply contacting their regular project lead. Our analytics team is also readily accessible and available to explore questions, develop a plan for RHT Program or other reporting, and explore potential dashboard and reporting opportunities that can support your team. To get started, just contact me or Amy Kinner, Onpoint's Director of Health Analytics at any time.