Governor Glenn Youngkin yesterday announced the launch of Virginia’s rural health transformation program stakeholder engagement process, part of a comprehensive effort to support providers and improve health outcomes for Virginians in rural communities. Congress recently enacted H.R. 1, otherwise known as the “One Big Beautiful Bill Act.” This law established the Rural Health Transformation (RHT) Program, a significant federal initiative designed to strengthen health care in rural communities nationwide. Between Fiscal Years 2026 and 2030, the program will distribute $50 billion across the country. Virginia is eligible to receive up to $500 million in direct state allocations—$100 million annually over the next five years—along with additional competitive grants based on rural health needs and capacity, totaling up to $1 billion for the next five years. This funding represents a significant opportunity to expand access to care, support the health care workforce, and improve service delivery in rural Virginia.
The purpose of the program is to ensure that families, providers, and communities in rural areas have the resources and support they need for sustainable, high-quality health care. Executive Directive 12, issued by Governor Glenn Youngkin, directs Virginia agencies and partners to prepare for these investments and align them with community priorities.
“The Rural Health Transformation Program, established by the One Big Beautiful Bill Act, gives Virginia a historic opportunity to expand access to care, support providers, and deliver better outcomes for rural families,” said Governor Glenn Youngkin. “We will work closely with local leaders, providers, and federal partners to ensure this investment reflects community priorities and delivers lasting improvements to Virginia’s rural health system.”
On August 27, Secretary of Health and Human Resources Janet Vestal Kelly formally kicked off the process by convening stakeholders to share the Commonwealth’s strategy for applying for new federal funding. This marks the beginning of a broader effort to craft Virginia’s strategy for the Rural Health Transformation Program established by H.R. 1, while ensuring that the perspectives of rural communities, providers, and families remain central to the process.
The Commonwealth’s submission to the Centers for Medicare & Medicaid Services (CMS) is due in November. H.R. 1 designates the following ten key activity areas eligible for funding, from which Virginia will identify and prioritize those most aligned with the needs of its rural communities:
- Chronic disease prevention and management programs
- Payments to providers for health care services or items
- Consumer-facing technology for chronic disease management
- Rural care delivery technology adoption (e.g., AI, robotics)
- Rural workforce recruitment and retention (minimum 5-year commitment)
- Information technology to improve efficiency, cybersecurity, and patient outcomes
- Adjusting rural health care delivery systems and service lines
- Support for substance use treatment and mental health services
- Innovative care models and payment systems
- Other CMS Administrator-approved activities that promote rural health care
As part of this process, Virginia health agencies will engage directly with stakeholders in rural communities to gather input and ensure the plan reflects local needs. Stakeholders are also invited to share ideas and proposals in the following areas by emailing [email protected] through September 15th:
- Proposals to improve rural health care delivery or access that are informed by national best practices
- Community perspectives from patients, providers, or caregivers on current challenges and opportunities
- Data or studies that can inform the Commonwealth’s understanding of rural health needs.
- Partnership concepts for piloting or scaling solutions that strengthen health care access and outcomes
- Existing plans and analyses, such as rural health reports, strategic plans, or data that organizations have already developed
Stakeholders submitting detailed proposals are asked to limit each submission to no more than 10 pages. Proposals should include:
- Program Summary: A brief overview of the proposed initiative and its goals for strengthening rural health in Virginia.
- Program Details: A description of target health outcomes, planned activities, and focus geographies or populations, as well as an indication of which of the ten CMS-approved activity areas the proposal addresses.
- Implementation Plan: An outline of how the program will be carried out, including milestones, key organizations or partners involved, roles and responsibilities, and high-level investment needs.
- Measuring Success: Defined metrics to track both short- and long-term progress and outcomes.
- Sustainability Plan: An explanation of how the program will continue beyond five years; for pilot initiatives, plans to measure success and potential for scaling.
Stakeholders are encouraged to submit proposals and feedback by emailing [email protected]. The deadline for all feedback submitted to the email inbox is September 15, 2025
