Maryland is officially moving forward with a major rural health investment: the Maryland Department of Health (MDH) has announced a first-year award of $168,180,837.61 through the Centers for Medicare & Medicaid Services (CMS) Rural Health Transformation Program (RHTP).
This five-year program is designed to help states strengthen rural health systems through workforce development, care delivery modernization, stronger connectivity and access, and strategies that address upstream drivers of health—like food access.
Below is a practical overview of what Maryland is prioritizing and how the initiative is structured.
What is the CMS Rural Health Transformation Program?
The Rural Health Transformation Program (RHTP) is a national CMS initiative intended to support state-led strategies that improve rural health outcomes, expand access to care, and build long-term rural health infrastructure.
CMS structured the program as a five-year investment, with funds distributed annually and states implementing initiatives that align with CMS goals for rural access, quality, and system sustainability.
Maryland’s RHTP approach: 3 initiatives + 2 funding tracks
MDH’s proposal is organized into three major “Initiatives,” and each Initiative is split into two funding tracks:
Immediate Impact Funds – designed for shovel-ready activities that can be implemented quickly
Transformation Funds – intended for longer-term, competitive initiatives requiring deeper planning and broader change
Think of it as: “what can we launch now?” plus “what do we want to permanently upgrade over time?”
Initiative 1: Transform the Rural Health Workforce
Maryland is putting real weight behind workforce pipeline + retention, especially in roles that keep rural systems functional day-to-day.
Immediate Impact priorities
New apprenticeships and expanded certificate programs for community health workers, nursing assistants, and peer recovery
Expansion of Area Health Education Centers (AHECs) to connect rural students with hands-on experience and clinical rotations
Improved information technology for workforce development
Transformation Funds priorities
- Pipeline programs for career exploration, upskilling, and public health service corps
- Training, recruitment, and retention for physicians and advanced practice professionals
Initiative 2: Promote Sustainable Access and Innovative Care
This is the “make care easier to reach, easier to deliver, and easier to coordinate” category—where technology and service delivery upgrades can make rural systems more resilient.
Immediate Impact priorities
Expanded rural capacity for primary care, specialty care, and School-Based Health Centers
Improved efficiency of local agency care provision
Better-equipped trauma response
Expanded/optimized HIT connectivity
Infrastructure to support broader telehealth adoption
Transformation Funds priorities
- Sustainable access via expanded healthcare capacity and integrated technology
- Mobile health in each rural region
- Provider support to adopt value-based, innovative care
- Behavioral health expansion across the full care continuum
Initiative 3: Empower Rural Marylanders to Eat for Health
Maryland is treating food access like the health issue it is (because… it is). This initiative includes both supply-side infrastructure and community access strategies.
Immediate Impact priorities
Post-harvest infrastructure for small farms to supply local markets with fresh food
Support for grocers and mobile markets in hunger “hot spots”
Nutrition education to build demand for healthy foods
Regional planning and coordination for healthy food access
Transformation Funds priorities
Food aggregators and food hubs to increase availability of affordable local foods
Organizational purchasing strategies to shift procurement toward healthy, local foods
What happens next?
MDH has indicated they are working through ongoing coordination with CMS and that program updates—including participation opportunities and future proposal or committee details—will be posted as the initiative progresses.
In short: funding is real, priorities are defined, and now the implementation and partnership phase begins.
