Rural Health Transformation and Federal Policy Updates

State implementation of the $50 billion Rural Health Transformation Program is moving quickly, but funding models, eligible organizations, application processes, and reporting expectations vary by state. In this episode of PYA's Let's Get Rural series, Jane Jerzak, Kathy Reep, and Tracy Purcell explain direct-to-provider, aggregator, and hybrid RHTP models and review examples from North Dakota, Oklahoma, Tennessee, Kansas, and Arkansas. The presenters discuss practical considerations for reviewing funding opportunities, budgeting allowable costs, aligning project outcomes with state goals, planning for sustainability, and building audit-ready documentation. They also address single audit and subrecipient considerations for organizations receiving or administering federal awards. The episode also covers provider-based department requirements, the proposed CJR-X bundled payment model, proposed 340B payment changes, 2027 obstetrical billing revisions, Rural Health Clinic telehealth coding, and federal legislation related to hospital transparency and rural facility support. The discussion was recorded July 30, 2026, and regulatory or legislative status may have changed since recording.