Granite State’s Award the Highest Among New England States

CONCORD, NH – To mixed reviews, Gov. Kelly Ayotte announced that the U.S. Centers for Medicare and Medicaid Services has awarded New Hampshire over $204 million for 2026 as part of the federal Rural Health Transformation Program, the largest award among New England states.

Throughout the process, Gov. Ayotte has personally advocated for New Hampshire to receive this funding with both CMS Administrator Dr. Mehmet Oz and U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr., according to Ayotte’s news release.

“I am pleased that New Hampshire will receive over $204 million in 2026 to transform and strengthen rural health care across our state. We did this the New Hampshire way — with input from our providers, community health and mental health centers, other rural health stakeholders, and feedback from Granite Staters, and the hard work paid off,” said Governor Kelly Ayotte. “This is the beginning of a bold effort to expand access to affordable, high-quality care closer to home for Granite Staters in rural communities. I thank CMS for awarding us this critical funding, and I look forward to putting our innovative plan into action in the new year so we can deliver a healthier future for all of New Hampshire.”

Sen. David Rochefort, R-District 1, said in an email: “The governor contacted me earlier today and told me the good news. I am thrilled to learn of this award and commend the governor, DHHS, CMS, and our providers for getting it done. Rural communities feel the strain of limited access, workforce shortages, and long travel times first and worst and this $204 million investment recognizes that reality. I appreciate the collaborative effort that took place to get this application done on a very short timeline and I look forward to the real results it will deliver to rural families across New Hampshire, and particularly in Senate District-1.”

Rep. Jerry Stringham, D-Lincoln, said in an email: “I am pleased that New Hampshire will be receiving $204 million in grant funding to promote rural health and that input from organizations like Mid-State Health and from many others in Grafton County, among many others, were included in the proposal.

“However, I am concerned that deep Medicaid cuts and the creation of Medicaid premiums — made by both Donald Trump and Kelly Ayotte — will dwarf any positive impact that these one-time grants may provide for rural health. In Grafton County, we’ve already lost a health facility as a result of Medicaid cuts and other providers are at risk of shutting their doors. I fear this grant is just applying a band-aid to a bullet hole — the bleeding won’t stop,” Stringham said.  

The grant award follows months of collaboration among the Governor’s Office, the Executive Council, and the New Hampshire Department of Health and Human Services (DHHS) to collect input from rural health stakeholders and seek feedback directly from Granite Staters.

New Hampshire DHHS Commissioner Lori Weaver said: “It was important that the Department hear from as many stakeholders as possible as we worked to transform rural health care delivery in New Hampshire. I am grateful to all who provided input and look forward to working together to implement our plans and meet our goals.”

Ayotte established the Governor’s Office of New Opportunities & Rural Transformational Health (GO-NORTH) to oversee implementation of the program in New Hampshire. New Hampshire’s Rural Health Transformation Grant application, with input from more than 300 stakeholders, including hospitals, rural health care providers, community health centers, and direct feedback from Granite Staters, focused on the following areas, according to Ayotte’s news release:

• “Make Rural America Healthy Again: Support rural health initiatives and new access points to promote preventive health and address root causes of diseases. Projects will use evidence-based, outcomes-driven interventions to improve disease management, behavioral health, and prenatal care.  
• Sustainable Access: Help rural providers become long-term access points for care by improving efficiency and sustainability. With RHT Program support, rural facilities work together – or with high-quality regional systems – to share or coordinate operations, technology, primary and specialty care, and emergency services.
• Innovative Care: Spark the growth of innovative care models to improve health outcomes, coordinate care, and promote flexible care arrangements. Develop and implement payment mechanisms incentivizing providers or Accountable Care Organizations (ACOs) to reduce health care costs, improve quality care, and shift care to lower cost settings.
• Technology Innovation: Foster use of innovative technologies that promote efficient care delivery, data security, and access to digital health tools by rural facilities, providers, and patients. Projects support access to remote care, improve data sharing, and strengthen cybersecurity, and invest in emerging technologies.
• Workforce Development: Attract and retain a high-skilled health care workforce by strengthening recruitment and retention of healthcare providers in rural communities. Help rural providers practice at the top of their license and develop a broader set of providers to serve a rural community’s needs, such as community health workers, pharmacists, and individuals trained to help patients navigate the healthcare system.”
• Ayotte said implementation planning is underway, with initial investments expected to support rural providers and communities beginning in 2026. In anticipation of the CMS award, the Governor and Council and the Joint Legislative Fiscal Committee earlier this month approved an accept and expend for the anticipated grant award for the current biennium. The amount awarded today by CMS is for federal fiscal year 2026.

A summary of New Hampshire’s Rural Health Transformation program application is available at https://www.dhhs.nh.gov/sites/g/files/ehbemt476/files/documents2/rht-summary.pdf.

For more information, please visit https://www.dhhs.nh.gov/programs-services/medicaid/rural-health-transformation-program.