RHTCMS332042
Cooperative Agreement
Overview
Grant Description
North Carolina Rural Health Transformation Program - Project Abstract / Summary
Organization: The North Carolina Department of Health & Human Services (NCDHHS), as the governor’s designee, will lead the North Carolina Rural Health Transformation Program (NCRHTP) through its Office of Rural Health.
Implementation is guided by a statewide steering committee that includes Medicaid, public health, and behavioral health divisions.
Key subrecipients include the Duke-Margolis Health Policy Center, UNC the Cecil G. Sheps Center for Health Services Research and others to be determined.
Project Goals: This transformative investment improves health outcomes and access for nearly 3 million rural North Carolinians across 85 of 100 NC counties through three goals; (1) catalyzing innovative care models, (2) transforming the rural care experience, and (3) creating a sustainable rural delivery system.
By FY2031, NCRHTP will increase rural provider-to-population ratios, reduce preventable hospital readmissions and emergency visits, lower chronic disease risk factors, and expand access to integrated behavioral, mental health and substance use services.
All while simultaneously investing directly into communities and stimulating rural economic development and job creation.
Total budget $1,000,000,000 over 5 years (indicative per CMS guidance).
Fund Usage: Through 6 integrated initiatives, NCRHTP will sustainably transform rural health.
1. Launch “NC Roots”* hubs. These locally governed, community-tailored networks connect medical, behavioral, and social services--making it easier for rural residents to access comprehensive care in one place.
Each hub is tailored to its region, offering in-person services, care coordination, and direct support for families, while also leveraging virtual care and advanced AI to enhance access and share data.
2. Improve prevention/screening, chronic disease management, maternal health, and nutrition by scaling up effective programs for primary care access, food as medicine, diabetes and hypertension management, cancer screening, and perinatal health.
3. Expand behavioral health and substance use disorder (SUD) services and integrate into regional care networks through the growth of certified community behavioral health clinics (CCBHCs), enhanced assessment and treatment programs to address critical care gaps, as well as new collaborative and non-traditional workforce models to connect residents to care.
4. Modernize and sustain the rural health workforce through catalyzing investments in rural training centers, fellowships, and certification programs to recruit, train, and retain clinicians, allied health professionals, and community health workers.
5. Advance value-based payment (VBP) by establishing capabilities for rural primary care practices to participate in advanced VBP models and laying the groundwork for rural hospital participation in VBP arrangements, with a focus on financial sustainability.
6. Accelerate technological innovation, access, and interoperability through increased health information exchange participation, digital literacy programs to ensure rural residents can access modern, connected care, and the broad implementation of state-of-the-art AI-based technology to support documentation and real-time expert clinical decision support to drive down business costs for rural providers and improve sustainability.
*Rural Organizations Orchestrating Transformation for Sustainability
Organization: The North Carolina Department of Health & Human Services (NCDHHS), as the governor’s designee, will lead the North Carolina Rural Health Transformation Program (NCRHTP) through its Office of Rural Health.
Implementation is guided by a statewide steering committee that includes Medicaid, public health, and behavioral health divisions.
Key subrecipients include the Duke-Margolis Health Policy Center, UNC the Cecil G. Sheps Center for Health Services Research and others to be determined.
Project Goals: This transformative investment improves health outcomes and access for nearly 3 million rural North Carolinians across 85 of 100 NC counties through three goals; (1) catalyzing innovative care models, (2) transforming the rural care experience, and (3) creating a sustainable rural delivery system.
By FY2031, NCRHTP will increase rural provider-to-population ratios, reduce preventable hospital readmissions and emergency visits, lower chronic disease risk factors, and expand access to integrated behavioral, mental health and substance use services.
All while simultaneously investing directly into communities and stimulating rural economic development and job creation.
Total budget $1,000,000,000 over 5 years (indicative per CMS guidance).
Fund Usage: Through 6 integrated initiatives, NCRHTP will sustainably transform rural health.
1. Launch “NC Roots”* hubs. These locally governed, community-tailored networks connect medical, behavioral, and social services--making it easier for rural residents to access comprehensive care in one place.
Each hub is tailored to its region, offering in-person services, care coordination, and direct support for families, while also leveraging virtual care and advanced AI to enhance access and share data.
2. Improve prevention/screening, chronic disease management, maternal health, and nutrition by scaling up effective programs for primary care access, food as medicine, diabetes and hypertension management, cancer screening, and perinatal health.
3. Expand behavioral health and substance use disorder (SUD) services and integrate into regional care networks through the growth of certified community behavioral health clinics (CCBHCs), enhanced assessment and treatment programs to address critical care gaps, as well as new collaborative and non-traditional workforce models to connect residents to care.
4. Modernize and sustain the rural health workforce through catalyzing investments in rural training centers, fellowships, and certification programs to recruit, train, and retain clinicians, allied health professionals, and community health workers.
5. Advance value-based payment (VBP) by establishing capabilities for rural primary care practices to participate in advanced VBP models and laying the groundwork for rural hospital participation in VBP arrangements, with a focus on financial sustainability.
6. Accelerate technological innovation, access, and interoperability through increased health information exchange participation, digital literacy programs to ensure rural residents can access modern, connected care, and the broad implementation of state-of-the-art AI-based technology to support documentation and real-time expert clinical decision support to drive down business costs for rural providers and improve sustainability.
*Rural Organizations Orchestrating Transformation for Sustainability
Funding Goals
REFER TO NOFO
Grant Program (CFDA)
93.798
Funding Agency
Place of Performance
North Carolina
United States
Geographic Scope
State-Wide
Related Opportunity
North Carolina Department Of Health & Human Services was awarded
NC Rural Health Transformation Program
Cooperative Agreement RHTCMS332042
worth $213,008,356
from Centers for Medicare and Medicaid Services in December 2026 with work to be completed primarily in North Carolina United States.
The grant
has a duration of 4 years 10 months and
was awarded through assistance program 93.798 .
The Cooperative Agreement was awarded through grant opportunity Rural Health Transformation Program.
Status
(Ongoing)
Last Modified 1/5/26
Period of Performance
12/29/25
Start Date
10/30/30
End Date
Funding Split
$213.0M
Federal Obligation
$0.0
Non-Federal Obligation
$213.0M
Total Obligated
Activity Timeline
Additional Detail
Award ID FAIN
RHTCMS332042
SAI Number
RHTCMS332042-3053844377
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
State Government
Awarding Office
75FCMC OFC OF ACQUISITION AND GRANTS MGMT
Funding Office
75FCME OFM – OFFICE OF FINANCIAL MANAGEMENT.
Awardee UEI
DKT3LLBWFVL3
Awardee CAGE
1W8J9
Performance District
NC-90
Senators
Thom Tillis
Ted Budd
Ted Budd
Modified: 1/5/26