A momentous opportunity for healthcare in Montana

The Rural Health Transformation Program (RHTP) was created by H.R. 1, the One Big Beautiful Bill Act, passed by U.S. Congress in July 2025. The program will provide $50 billion in federal grants to help protect and enhance rural healthcare across the country. Funding awards of varying levels will be released over the course of five years to all 50 states. The Centers for Medicare and Medicaid Services (CMS) lists five strategic goals of the program, including make rural America healthy again, sustainable access, workforce development, and tech innovation.

Given its high rurality, Montana will receive more than its equal share of those funds compared to many other states.

>>> Montana has secured a momentous investment to enhance rural healthcare here. For federal fiscal year 2026, Montana was awarded $233,509,359 — the fourth-highest award in the nation. Continued annual funding at this level means the state could receive more than $1 billion in the next five years.

RHTP Funding Priorities for Montana

CMS announced on December 29, 2025, that all 50 states would receive RHTP funding awards. For federal fiscal year 2026 (FY26), Montana was awarded $233,509,359. The total amount awarded to Montana over the five-year life of the program depends on several determinations by CMS, partially based on factors like rural population, portion of rural healthcare facilities, and status of healthcare providers.

Montana’s FY26 award of $233.5 million will be allocated to five key initiatives outlined in DPHH’s plan approved by CMS. According to DPHHS, it is anticipated that Montana will receive initial funding no later than March 1, 2026, with procurement and contract awarding taking place through June 2026.

>>> Local hospitals and healthcare providers benefit everyone in Montana’s rural communities. Getting RHTP funding on the ground and into these facilities will provide important investments for long-term operational, financial, and workforce challenges facing Montana’s rural healthcare system.

RHTP Updates for Members

MHA is closely tracking progress and is heavily engaged with the State as it moves forward with planning and implementation. As we have since H.R. 1’s passage, MHA will continue to provide resources and regular updates to members as information becomes available. Members can sign up to receive updates and action alerts by clicking here.

RHTP Information for Non-Members

If you’re part of a non-member organization interested in partnering with the MHA to help achieve the goals of the RHTP plan, click here to complete the partner interest form. Submitting this form will allow you to to share your company’s information and help us learn more about your work or activities with the Montana healthcare community.

Securing RHTP Funds for Your Facility

We expect that RHTP procurement processes will begin in March 2026. DPHHS has engaged the Montana Department of Administration (DOA) to conduct a procurement process and provided this general funding information:

• Most funds will be awarded through a competitive bidding process at bids.mt.gov. DPHHS encourages all interested organziations, including hospitals, to review or complete “vendor” registration in the State of Montana’s procurement system, eMACS, in preparation for participation. DPHHS has provided resources for vendors interested in upcoming RHTP Request for Proposals (RFPs) including a vendor checklist and FAQ document. 
• Other awards methods may include grant applications or inter-agency contracts (e.g., with the Department of Labor & Industry). If direct funding opportunities for communities and providers become available, they will be announced at ruralhealth.mt.gov.

This follows planned work in early 2026 to stand up key partnerships, design programs, identify key institutions and sites, finalize governance structures, and begin procurement and contracting. MHA will provide funding updates as information becomes available. Members can sign up to receive updates and action alerts by clicking here.

We believe the State will prefer to work with a smaller number of statewide partners to efficiently deliver program support and funding to distinct sections of Montana’s healthcare system, rather than working individually with thousands of healthcare providers and partners.

MHA plans to respond to certain requests the State might issue for RHTP program support and stands ready to serve as a strategic partner through the Montana Health Research and Education Foundation (MHREF). MHREF’s deep experience in federal grant administration, proven partnership with the State, and unique understanding of hospitals of all sizes and types will be a benefit to the membership and to Montana’s rural communities. Ultimately, the goal is to support distribution to the membership with a focus on rural hospitals and systems of care outlined in H.R. 1, especially those with limited resources to pursue and administer highly restricted federal funds.

Montana’s Congressional delegation heard directly from MHA and our members about the importance of protecting rural healthcare throughout the debates in Washington, D.C., prior to H.R. 1 passage. We continue to stay deeply engaged with our federal delegation. Continued, regular engagement with the State and DPHHS will include MHA representation on the program’s Stakeholder Advisory Committee, which will be in place for the life of RHTP. This engagement has provided important insight, dialogue, and participation opportunities during the fast-moving implementation phase of the program.