Governor Greg Gianforte and Charlie Brereton, Director of the Montana Department of Public Health and Human Services (DPHHS), have announced a $233 million federal investment aimed at improving rural health care in Montana. The funding comes from the Centers for Medicare & Medicaid Services (CMS) Rural Health Transformation Program (RHTP), part of a national initiative established by President Trump’s Working Families Tax Cuts legislation.
Montana’s allocation represents the first-year award in a five-year grant program, with the state expected to receive up to $1.2 billion over its duration. According to officials, this funding is intended to stabilize and modernize health care delivery in rural communities across Montana.
“With this unprecedented funding, we are taking a major step toward modernizing Montana’s rural health care systems,” Gov. Gianforte said. “Thanks to President Trump, we’re launching this program and making a long-term commitment to our rural communities by providing Montana families with the access to health care they deserve.”
The announcement follows CMS approval of Montana’s application, which was submitted by DPHHS in November. The state received the fourth-highest award among all 50 states.
“Every Montanan deserves top-level health care, no matter where they live,” Dir. Brereton said. “This landmark funding provides the resources we need to execute our plan, which includes stabilizing our most rural hospitals and bridging the health care divide for families living in every corner of our state.”
DPHHS will now submit an updated budget proposal aligned with the new funding amount and will work with the Montana Office of Rural Health to organize biannual stakeholder meetings for ongoing public input. The first meeting is scheduled for January 22.
The department developed its RHTP application over seven weeks, focusing on sustainable initiatives that can continue beyond federal support. As implementation begins, DPHHS plans to set up an internal unit dedicated to administering the program and will select external partners through competitive processes.
DPHHS intends to collaborate with various stakeholders—including rural providers, hospitals, community organizations, tribal nations, Urban Indian Organizations, and other agencies—to deliver five core initiatives addressing specific challenges faced by rural health systems in Montana.
Key metrics such as glycemic status, hypertension rates, obesity levels, and suicide rates will be used for evaluating outcomes associated with RHTP-funded projects.
Public outreach played a significant role during application development; feedback was gathered from hospitals, more than 20 rural health stakeholders, all eight tribal nations and Urban Indian Organizations in Montana as well as through a webinar attended by 900 registrants and over 300 formal responses via a Request for Information process.
RHTP funds were distributed based on a formula: half divided equally among participating states; one quarter based on each state’s level of rurality; and one quarter determined by how closely each state’s plan aligns with CMS criteria.
Further details about RHTP are available at https://ruralhealth.mt.gov/. The CMS announcement regarding $50 billion awarded nationwide can be found at https://www.cms.gov/newsroom/press-releases/cms-announces-50-billion-awards-strengthen-rural-health-all-50-states.
