The Rural Health Transformation Program, enacted under the One Big Beautiful Bill Act, aims to improve access, care quality and infrastructure in rural communities.
The program created a $50 billion fund to distribute across all 50 states from 2026 to 2030. Half of the funding in fiscal 2026 was allocated equally across states. The remaining funds were awarded based on states’ rural population size, proposed policy actions and potential for impact. The average award was about $200 million, with the agency explicitly pushing for modernization and workforce development, and support in its funding methodology for the program.
Daniel Decker, MD, is a urologist and co-founder of Vitality Plus Urology Clinic in Mountain Home, Ark. Now in independent practice, Dr. Decker has worked in a variety of practice settings over the last decade and sees massive potential in the RHTP.
“This rural health deal, it was just like a slingshot of how quickly things happened,” he said, noting the various buckets of investment outlined in the program, including innovation, workforce support and expanded preventive care.
Preventive care, in particular, is one area where Dr. Decker sees many areas of investment and enhancement of services.
“As a surgeon, we do a lot of interventions,” he said. “But a lot of the stuff I deal with, like incontinence, is a lifestyle preventive. … Obesity, especially in the South, is approaching 50% and affects everything, [including] surgery. And in rural areas, like where I live, there’s still a ton of smoking, and smoking leads to bladder cancer just as much as lung cancer.”
This has resulted in the expansion of preventive services throughout his network, including the development of outpatient facilities focused on wellness and prevention, weight loss and hormone treatments.
Innovation, including the expansion of robots for surgery, are top priorities for Dr. Decker, as is the improvement of services like transportation to better connect existing healthcare services in the area.
“Part of the problem, like in obstetrics, for instance, is that they’re just not getting to their prenatal visits — and it’s not because they don’t want to. It’s [about] getting a ride,” he said. “When I do surgery, there are so many times we’ve got to have someone drive them home. The state has some transportation programs, the nursing home has transportation, the surgery center has transportation … but it’s all piecemeal.”
He said that his organization has been able to utilize AI to piece together each individual schedule of the fragmented transportation network, creating an easy-to-use resource for Dr. Decker’s ASC.
The key to the RHTP’s success will be in its ability to place this funding as directly into the hands of patient-facing providers as possible, he added.
“[W]hat we need to do is get back to letting the people who are seeing these [programs] be involved in this,” he said, “I think it’s [important] to have a bigger voice in what we’re seeing in patients.”
