Hawaiʻi has been awarded $188,892,440 through the federal Centers for Medicare & Medicaid Services’ (CMS) Rural Health Transformation Program (RHTP) as part of a $50 billion national investment to strengthen rural healthcare in all 50 states.

The award will support implementation of the Hawaiʻi Rural Health Transformation Plan, a five-year strategy to modernize healthcare delivery across Hawaiʻi’s rural and neighbor-island communities, where 95.1% of the state’s land area is rural and access to care is limited by geography, workforce shortages and infrastructure gaps. The $188,892,440 award covers federal fiscal year 2026 and represents the first year of funding, with additional annual awards expected through 2030.

The resulting plan centers on the following six coordinated initiatives:

• Rural Health Information Network (RHIN) — A statewide digital backbone linking rural hospitals, clinics and health centers through interoperable electronic health records, wireless networks and shared data hubs.

• Pili Ola Telehealth Network — A statewide telehealth system connecting rural communities to providers while expanding virtual care and telehealth training.

• Rural Infrastructure for Care Access (RICA) — Expansion of emergency medical services, mobile healthcare, community paramedicine and behavioral health capacity in rural areas.

• HOME RUN (Hawai‘i Outreach for Medical Education in Rural Under-resourced Neighborhoods) — A workforce pipeline providing training, residencies, scholarships and mentoring to recruit and retain rural healthcare professionals.

• Rural Respite Network — Expansion of the medical respite model to rural communities to reduce avoidable hospitalizations among unhoused and post-acute patients.

• Rural Value-Based Innovation and AHEAD Readiness Fund — A competitive fund to help rural providers adopt innovative, value-based care models and prepare for CMS’ AHEAD payment system.

The Governor’s Office will coordinate with CMS, state departments, healthcare providers and community organizations to implement the plan’s transformational improvements in access, quality, workforce stability and system sustainability across rural Hawaiʻi.

The state will review approved uses of funds once released. More information on full program details and allowable uses of funds will be released soon.