In an ambitious bid to transform health care services across the state’s rural areas, the North Carolina Department of Health and Human Services (NCDHHS) has presented its Rural Health Transformation Plan to the Centers for Medicare & Medicaid Services (CMS). This proposal aims to leverage $200 million annually from federal funds over a span of five years to enhance healthcare quality in 85 of the state’s 100 counties. A decision from CMS regarding the funding is anticipated by the end of 2025.
The program seeks to guarantee high-quality, affordable healthcare for all North Carolinians, regardless of their location. The NCDHHS crafted this plan through collaboration with over 420 stakeholders, such as rural hospitals, community health centers, and local health departments, alongside input from Tribal communities and residents.
“Our plan reflects North Carolina’s commitment to ensuring that every North Carolinian, no matter where they live, has access to high-quality health care,” stated Governor Josh Stein. He emphasized the state’s leadership in rural healthcare innovation and thanked bipartisan partners for their contributions to the plan’s development.
NC Health and Human Services Secretary Dev Sangvai added, “Rural health care providers are the backbone of their communities, working tirelessly to ensure people have access to care when and where they need it.” He noted that the plan is part of broader efforts to support over 3 million rural residents in North Carolina.
With the second-largest rural population in the U.S., after Texas, North Carolina faces distinct challenges, including workforce demands. The proposed Rural Health Transformation Plan includes six strategic focuses:
- Establishing an “NC ROOTS” Hub to integrate medical, mental health, and social services
- Extending prevention and chronic disease management programs
- Boosting access to mental health and substance use disorder services
- Enhancing the rural healthcare workforce
- Assisting rural providers in adopting value-based care models
- Improving healthcare technology
Implementation will involve a coalition of state agencies, community organizations, academic institutions, rural providers, and private-sector partners. A notable component is the Rural Health Infrastructure Fund (RHIF), aimed at ensuring rural healthcare providers have the technology needed to support their operations.
NCDHHS has scheduled a briefing for November 21 with North Carolina’s congressional delegation and General Assembly members to discuss the plan’s objectives and statewide impact, emphasizing federal collaboration in addressing disease root causes.
Approval from CMS is expected by December 31, with the program set to commence in early 2026. Following approval, a public notice will be issued, and further details about the funding process will be provided. The initiative will be overseen by a statewide committee, including NCDHHS’s Office of Rural Health, Medicaid divisions, Public Health, and Mental Health, collaborating with universities, community colleges, Community Health Centers, and other local partners.
Ultimately, the program aims to enhance healthcare delivery for nearly 3 million rural residents, support over 400 rural health facilities, and bring substantial federal investment into the state. Interested individuals can find more information about the Rural Health Transformation Program by visiting www.ncdhhs.gov/rhtp.
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