Senator Budd Issues Statement After CMS Announces $213M+ in Funding for North Carolina’s Rural Hospitals
Washington, D.C. — Earlier this month, U.S. Senator Ted Budd (R-N.C.) joined members of the North Carolina congressional delegation in sending a bipartisan, bicameral letter to the Administrator for the Centers for Medicare and Medicaid Services (CMS), Dr. Mehmet Oz, expressing strong support for the North Carolina Department of Health and Human Service’s (DHHS) Rural Health Transformation Program (RHTP) application. Today, CMS allocated $213,008,356 in funding for North Carolina’s rural hospitals, which was previously approved in the Working Families Tax Cut Act signed into law earlier this year.
In a statement following the announcement, Senator Budd said:
“North Carolina has the second-largest rural population in America, home to 7.6% of our nation’s rural residents. Today’s announcement by the Centers for Medicare & Medicaid Services (CMS) of $213 million from the Rural Health Transformation Program will greatly benefit patients across our state. While I was proud to support the inclusion of this funding in the Working Families Tax Cut Act, it is unfortunate that the State’s application was not appropriately coordinated with federal officials and did not request funding levels that more accurately correlate with our significant rural population.”
Read the full text of the letter HERE and below.
Dear Administrator Oz:
As members of the North Carolina congressional delegation, we express our strong support for the North Carolina Department of Health and Human Services’ (DHHS) Rural Health Transformation Program (RHTP) application. We respectfully request that you approve the application in full before the December 31 deadline. Approval will allow our state, which has three million rural residents across 85 counties—the second-largest rural population in the nation—to expand proven innovative models, foster sustainable innovation, and strengthen our rural workforce.
While our state’s application requested a funding amount equal to 2 percent of total RHTP dollars available, North Carolina accounts for 7.6 percent of the rural population nationwide, so we are requesting that CMS allocate additional dollars so that the total funding amount is proportional to the disproportionately large rural population in our state. Per existing Centers for Medicare & Medicaid Services (CMS) guidance, North Carolina applied the Health Resources and Services Administration (HRSA) definition of rural, which excludes counties like Burke, Moore and Pitt, with respective populations of 88,000, 108,000 and 180,000, yet includes counties like Wake, which is a primarily urban county home to over 1.2 million residents. Moore, Pitt, and similar jurisdictions serve some of the most isolated patients living in the most rural and even remote areas, and we look forward to ensuring all our rural providers and patients receive funding commensurate with their level of need.
After applying on November 3, DHHS plans to allocate awarded funds through its Office of Rural Health (NCRHTP). A statewide steering committee, including Medicaid, Public Health, and Behavioral Health divisions, would guide implementation. The program allows sufficient flexibility for the Centers for Medicare & Medicaid Services to assign recipients. As population declines continue and rural hospitals increasingly rely on Medicaid, rural communities face ongoing healthcare and economic challenges, with gaps in access to care and quality. At least 24 counties lack adequate primary care, and 90 counties are designated mental health shortage areas. Since 2006, 12 rural hospitals have closed, with seven closures in eastern North Carolina.
An RHTP investment will improve health outcomes and access for nearly three million rural North Carolinians, advancing innovative care models, transforming the rural care experience, and creating a sustainable rural delivery system. By FY2031, NCRHTP aims to increase rural provider-to-population ratios, reduce preventable hospital readmissions and emergency visits, lower chronic disease risk factors, and expand access to integrated behavioral, mental health, and substance use services. Locally governed, community-tailored networks will connect medical, behavioral, and social services, making it easier for rural residents to access comprehensive care in one place.
Each hub is tailored to its region, offering in-person services, care coordination, and direct family support, while also leveraging virtual care and advanced AI to improve access and data sharing. These efforts will provide an opportunity to accelerate technological innovation, access, and interoperability through expanded health information exchange participation, digital literacy programs to ensure rural residents can access modern, connected care, and the broad implementation of state-of-the-art AI-based technology to support documentation and real-time expert clinical decision support to drive down business costs for rural providers and improve sustainability.
Approving North Carolina’s application for the RHTP will improve health outcomes and our economy, which relies on healthy communities to thrive. We are grateful for your full and fair consideration of this crucial award ahead of the December 31 deadline.
Sincerely,
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