New Hampshire eyes $500 million in federal grants to improve rural health care

With half a billion dollars in federal funding on the line, Gov. Kelly Ayotte has announced the creation of a new independent entity to oversee the transformation of rural health care in New Hampshire. 

The goal is to make care more affordable, accessible, and sustainable for communities in rural parts of the state.

Last month, New Hampshire submitted its application for a share of the $50 billion federal Rural Health Transformation Program, part of the One Big Beautiful Bill Act and administered by the Centers for Medicare and Medicaid Services. 

“We’ve put together a bold, innovative plan to expand access to care, and we did it the New Hampshire way — with input from providers, community health centers, other rural health stakeholders, and the public,” Ayotte said in a statement. 

As part of the effort, Ayotte established the Governor’s Office of New Opportunities & Rural Transformational Health (GO-NORTH) — an independent unit within her office intended to cut through bureaucracy and accelerate ideas.

GO-NORTH will work closely with the state Department of Health and Human Services to leverage state expertise while maintaining flexibility.

“We’re excited to get to work with our partners to transform rural health care in New Hampshire. From promoting mental and physical health to pioneering new workforce recruitment and payment models, this opportunity reflects the beginning of a healthier future for people in every corner of our state,” DHHS Commissioner Lori Weaver said in a statement. 

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The expected allocation of funds for New Hampshire is approximately $100 million per year, totaling $500 million over five years beginning in 2026. However, the final amount awarded to the state will ultimately be determined by the federal government.

The state’s grant application draws on feedback from more than 300 stakeholders, including hospitals, rural health providers, community health centers, and members of the public.

Goals include expanding behavioral and mental health services, improving chronic disease management, and addressing access challenges in northern regions of the state, where limited transportation options make it difficult for residents to reach hospitals and emergency medical services.

Another major focus is retaining and strengthening the rural health workforce through training, education, and new recruitment strategies. The plan also prioritizes financial sustainability through introducing innovative payment models and modernized care delivery systems.

“This application reflects the voices and hopes of Granite Staters who live, work and serve in our rural communities,” Weaver said.

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