New CMS Rural Health Fund: The Need for Medical Transportation to be Integrated in Project Proposals

The $50 billion Rural Health Transformation (RHT) program launched by CMS represents one of the most significant federal investments in rural health in decades (CMS RHT Program). States that secure funding will have a once-in-a-generation opportunity to reshape healthcare delivery in rural areas- if they build systems that patients can actually reach.

Even the best hospitals or clinics mean little if no one can get there. Transportation is often the invisible barrier to access. Without integrating mobility solutions, strategic health investments risk falling short of their promise.

At MedHaul, our mission is to help every stakeholder embed medical transportation as a core, measurable component of rural health transformation. Below is a refined look at the case for transportation and how to make it part of winning RHT proposals.

Fast Facts: What the RHT Program Enables 

Budget & Allocation Mechanics

• $50 billion total, allocated over five fiscal years (2026–2030), with $10 billion per year.
  
• Half of each year’s funds (the “baseline funding”) are distributed equally to all states that submit and receive approved applications.
  
• The other half (“workload funding”) is awarded based on state-level factors including rural population, existing rural health facilities, and the quality of planned state initiatives.
  
• States must propose initiatives covering at least three of CMS’s approved categories, such as technology/IT investment, innovative care models, prevention and chronic disease, workforce, and provider payments.
  

Strategic Goals & Use-of-Funds Options‍

The RHT program has clearly articulated goals: sustainable access, workforce development, tech innovation, prevention & chronic disease, and system redesign.

Importantly, among the allowable uses are:

• Providing technical assistance, software, and hardware to enable health system transformation (IT, data, interoperability)
• Fostering consumer-facing, technology-driven solutions for prevention, chronic disease, or care coordination
• Initiatives to improve access to care (e.g. integrating telehealth, evaluation of service gaps)
  

Why Transportation Needs to Be Explicitly Built Into RHT Plans

Transportation is not an afterthought- it is the connective tissue of rural health. Every clinic, telehealth platform, or community workforce initiative envisioned under the Rural Health Transformation (RHT) program depends on one critical question: Can patients actually get there?

Too often, transportation is siloed, underfunded, or treated as a local logistics problem instead of a statewide health access strategy. But the data is unambiguous: without intentional, funded mobility solutions, even the most advanced health investments will miss the people they’re meant to serve.

When rural families face a 45-minute drive to the nearest hospital, or older adults depend on neighbors for rides that may not come, “access” becomes theoretical. In these communities, transportation is healthcare infrastructure, and is as essential as broadband, workforce, or primary care recruitment.

‍The Evidence Is Clear:

Distance and geography: In many rural settings, patients live 30+ miles from primary or specialty care. Distance strongly correlates with reduced utilization of services. (Journal of Transport & Health)

‍Sparse transit infrastructure: Many rural areas lack any fixed-route public transit, and service is often unreliable. (RHIHub)

‍Transportation gaps lead to missed care:

• Transportation barriers contribute to delayed care, reduced outpatient visits, more ED usage, and hospital readmissions. (PMC)‍
• In a rural region study, having transportation access strongly predicted health care utilization. (PubMed) ‍‍

Demographic and equity disparities:

• Lower-income and minority populations disproportionately rely on public transit or ride-share, and often incur substantial additional travel time. (JAMA)‍
• Among older rural residents, 67% reported at least one transportation barrier (e.g. limited hours, scheduling, physical access) (PubMed) ‍

Outcomes misalign without measurement. If state grantees are only evaluated on clinic visits or telehealth uptake, there's no accountability for people who couldn’t get there.

Taken together, the data underscores that mobility is not a peripheral add-on- it is a core enabler of rural health equity.

How to Get Involved

If your goal is to ensure that transportation plays a role in RHT implementation, here’s how each stakeholder type can act:

• State agencies / state health departments / Medicaid offices
   • Integrate mobility in stakeholder planning and RFIs
   • Propose NEMT or regional transport pilots within access initiatives
   • Align RHT performance metrics to include travel burden, missed trips, access gaps
   • Reserve RHT sub-award funds for transportation tech and vendor contracts
  
  
• Providers (hospitals, clinics, providers)
   • Engage early in state planning forums
   • Submit letters or concept briefs supporting transport components
   • Share local data on travel burdens, missed visits, catchment maps
   • Partner now with mobility vendors for pilots or proofs of concept
  
  
• Technology / vendor teams
   • Reach out proactively to state health, rural health, Medicaid offices
   • Offer modular “plug-in” transport solutions that interoperate with health systems
   • Demonstrate prior track record or cost-benefit modeling
   • Prepare for federal grant compliance as subrecipients or contractors
  
  
• Advocates / nonprofits / foundations
   • Amplify the discourse on transportation as health equity
   • Offer matching or seed funding for mobility pilots
   • Provide TA (toolkits, templates, metric language) to states and clinics

How MedHaul is Here to Help

At MedHaul, we believe that transportation isn’t just a service- it’s the bridge between rural patients and the care systems built to serve them. As states design their Rural Health Transformation (RHT) plans, we stand ready to help partners translate policy vision into measurable access outcomes.

Our platform combines intelligent scheduling, routing optimization, and data interoperability tools that ensure hospitals, clinics, and payor systems are easily able to provide transportation to their patients. From helping states identify mobility gaps, to powering pilot programs that reduce no-shows and expand reach, MedHaul provides both the technology and expertise to make transportation a measurable success factor in RHT initiatives.

Whether you’re a state agency, health system, or vendor partner, our team can support you in:

• Designing transport-inclusive RHT strategies aligned with CMS goals and reporting frameworks
• Deploying software solutions that streamline NEMT coordination and track impact metrics (missed trip rates, travel times, appointment adherence)
• Establishing public–private partnerships that make rural access scalable and sustainable
  

You can learn more on state by state resources at the Rural Health Information Hub, or download MedHaul’s RHT Resources Tracker here: