Rural Transformation Fund Deadline Looms: States Face Tough Choices with Limited Time

by London Kelley
| Oct 23, 2025

THE BIG PICTURE: States have until November 5 to submit applications for their share of the $50 billion Rural Transformation Fund, creating a high-stakes rush to determine how these funds will reshape rural healthcare delivery.

WHY IT MATTERS: Over 20% of Americans live in rural areas where healthcare systems face unique challenges. The fund represents a significant opportunity to transform these systems, but comes with substantial limitations.

National Perspective

American Hospital Association President and CEO Rick Pollack emphasizes the importance of rural healthcare funding: “When it comes to rural hospitals and the whole rural health care delivery system, obviously over twenty percent of America lives in rural areas. So that’s always very important to us.”

Pollack notes that the implementation of the $50 billion Rural Transformation Fund is now one of the most pressing issues facing rural healthcare nationwide, with states rushing to meet application deadlines.

Utah’s Response

Matt McCullough, Rural Hospital Improvement Director and Rural 9 Network Director, outlines Utah’s approach to the funding opportunity while highlighting significant concerns:

  • The state has created four specialized working groups to develop its application
  • Utah’s top priority is workforce recruitment and retention for rural facilities
  • The funding, while substantial, doesn’t offset recent Medicaid cuts

“The whole idea of this grant is to transform rural health care and make it more sustainable financially, provide better quality,” McCullough explains. “So we have a real challenge ahead of us.”

The Challenge: Limited Time, Complex Decisions

With the November 5 deadline approaching rapidly, states face significant hurdles:

  • Developing comprehensive five-year transformation plans in a short time frame
  • Navigating strict federal restrictions on fund usage
  • Balancing immediate needs with long-term sustainability goals

The Bottom Line

The Rural Transformation Fund represents both an opportunity and a challenge for states like Utah. While the funding is welcomed, the compressed timeline and restrictions create significant pressure on states to develop thoughtful, effective plans that will truly strengthen rural healthcare systems for the long term.