December 30, 2025

CMS Announces Rural Health Transformation Program Awards

Earlier this week, the Centers for Medicare and Medicaid Services announced that all 50 states will receive awards under the new Rural Health Transformation Program. For 2026, Washington state is slated to receive $181,257,515, representing a one-year investment as part of this five-year federal initiative to strengthen rural health care systems.

The WSMA engaged extensively on behalf of the physician community in the development of Washington state's application, including meeting with state policymakers, submitting feedback on funding priorities, and lending formal support to the state's proposal. An abstract of Washington’s application released by CMS outlines the state's project goals, and we are pleased to see key elements the WSMA advocated for reflected in the plan, including investments in health care workforce, technology, and system capacity.

We are grateful to state agencies and the governor’s office for their collaboration and for the timely submission of a strong application to CMS. The WSMA will continue to engage with state partners and CMS to ensure physician perspectives remain central as these funds are deployed—and to advocate for investments that strengthen patient care, practice viability, and the long-term sustainability of rural health in Washington.

We will keep members informed as implementation details and stakeholder engagement opportunities become available.

Update (Dec. 31)

Just before press time, the governor's office released a press release with additional information on how the funds will be distributed:

" Washington specifically sought funding to help build a healthier, more resilient and financially sustainable rural health system. The Rural Health Transformation funding will help rural residents across all 39 counties. Of those, 22 counties are considered fully rural — Adams, Clallam, Columbia, Ferry, Garfield, Grant, Grays Harbor, Island, Jefferson, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Orielle, San Juan, Skamania, Stevens, Wahkiakum and Whitman. The funding will reach rural Washington residents in these counties, as well as the rural portions of the state’s remaining counties.

"Washington will use the funds to:

• Develop community-based health care options to help rural residents access the right level of care at the right time
• Invest in the health of Native families
• Invest in technology that increases efficiency, access and quality in Washington’s rural health care system, helping rural Washingtonians get specialty care and monitor chronic conditions
• Invest in long-term solutions will give rural Washingtonians better access to high-quality specialty and emergency medical care
• Grow, train and maintain the health care workforce in rural Washington
• Expand and sustain Washington’s rural behavioral health system, decreasing the strain on rural hospitals and school-based behavioral health care services

"The state will collaborate with Area Agencies on Aging, the Washington Hospital Association, the Rural Collaborative and others to target funding where it is needed most. It will also work with the state’s universities to expand existing programs and initiatives that benefit rural health care systems.

"For example, funds will be used to expand the University of Washington School of Medicine’s Project ECHO (Extension for Community Health Outcomes). ECHO offers a multidisciplinary tele-monitoring and education platform for Washington clinicians that helps providers deal with complex and specialized patient issues, infectious diseases, psychiatry and behavioral health and intellectual and developmental disabilities. Rural Heath Transformation program funds will help expand ECHO to additional health care facilities, as well as add new medical specialties."

Read the governor's press release.