$50 Billion Rural Health Transformation Opportunity

A legislative update from the AABC Government Affairs Committee

The CMS Rural Health Transformation (RHT) Program, established under the "One Big Beautiful Bill" Act, will distribute $50 billion to states over five years to strengthen rural health. The program prioritizes prenatal care and expanding access to eliminate maternity care deserts, with states planning to integrate community-based maternal support teams into their rural stabilization strategies.

What This Means for Your Birth Center

First-year funding (FY26) averages $200 million per state, supporting:

• Modernize Infrastructure: Expand digital maternal telemedicine and interoperability.
• Workforce Pipelines: Recruit and retain clinical staff with 5-year rural commitments.
• Payment Reform: Transition toward value-based care and alternative payment models

Action Items for AABC Members

1. Review Your State’s Plan: CMS has published State Project Summaries for all 50 states. Look up your specific state to see how they’ve allocated their RHT funds.
2. Connect Locally: The Office of Rural Health Transformation (ORHT) is coordinating through state-level offices. Contact your CMS Regional Rural Health Coordinator and your State Office of Rural Health to ensure community birth is represented in the "hub-and-spoke" models being designed.
3. Leverage the TMaH Model: If you are in a CMMI/TMAH state, coordinate your RHT efforts with the Transforming Maternal Health (TMaH) Model, which specifically aims to increase access to birth centers and midwives.
4. CMS Rural Health Transformation Program Overview
5. Full List of FY26 State Award Amounts & Initiatives

Rural demand for perinatal and primary birth services is rising—let’s ensure the birth center model is central to the transformation.