Ohio has submitted a comprehensive proposal to reshape rural healthcare delivery through the federal Rural Health Transformation Program (RHTP). The state hopes to capture significant funding from the One Big Beautiful Bill Act's $50 billion allocation while addressing chronic provider shortages and hospital sustainability challenges across rural regions.

The proposal replaces fragmented care models with coordinated health networks built around several key initiatives:

Rural Health Innovation Hubs – Every rural region will establish formal collaboration networks connecting hospitals, clinics, pharmacies, and behavioral health providers. New funding will support network development and Centers of Excellence.

Workforce Development – Ohio will invest in rural provider pipelines from high school through medical school with a focus on recruiting, training, upskilling, and spurring long-term employment opportunities in rural communities.

Policy Reforms – Legislative changes will expand pharmacist roles to include test-to-treat services. The state will join the EMS licensure compact and require nutritional education in continuing medical education for healthcare providers.

Chronic Disease Management – The Healthier Ohio Initiatives will embed Lifestyle Medicine across schools, clinics, and community programs. Schools will serve as wellness hubs integrating physical activity and nutrition education, building on Lt. Governor Jim Tressel's fitness challenge that currently engages over 185,000 Ohio students.

Technology Infrastructure – Expanding telehealth, remote monitoring, and upgrading EMS systems will enable real-time care coordination while reducing unnecessary emergency department visits. Enhanced EMR and HIE networks will facilitate data sharing among providers.

Maternal and Child Health – Ohio will expand evidence-based home visiting models to every rural community, improving health outcomes for moms and babies while building on recent success in reducing infant mortality rates.

Ohio's application requests up to $238 million annually in recurring funding plus $12.5 million in one-time start-up costs:

Annual Recurring Initiatives:

• Rural Health Innovation Hubs – $90–$125 million annually to formalize collaboration networks connecting hospitals, clinics, pharmacies, and behavioral health providers across every rural region.
• School-Based Health Centers – $20–$25 million annually to expand access to primary care in rural schools.
• OhioSEE Program – $25–$30 million annually to provide comprehensive vision, hearing, and dental care ensuring rural students can succeed academically.
• Healthier Ohio Initiatives – $15–$25 million annually for chronic disease management and behavioral health programs embedding Lifestyle Medicine across schools and community programs.
• Rural Health Workforce Pipeline – $10–$15 million annually for recruiting, training, and long-term employment programs spanning high school through medical school.
• Emergency Care Transformation – $12–$18 million annually for upgraded EMS systems, telehealth, and remote monitoring capabilities.

One-Time Start-Up Costs:

• Maternal & Infant Wellness Home Visiting – $6–$8 million to build nursing capacity and expand evidence-based models statewide.
• EMR Access for Pharmacies – $3–$4.5 million to enhance data sharing and care coordination capabilities.

CMS will evaluate state RHTP applications in the coming weeks, with awards set to be made by the end of 2025. Once Ohio’s share is confirmed, the state is expected to release funding opportunities beginning early next year.