Alaska’s Rural Health Transformation Program (RHTP) is closing out its first year with more than $240 million committed to roughly 250 projects, from pharmacy access in Tribal communities to emergency services on the Kenai Peninsula. The funding is Alaska’s share of the federal RHTP, a $50 billion CMS program that runs through 2030. Alaska’s $272 million Year 1 award was the largest per-capita award in the country, according to the Anchorage Daily News, and the Alaska Department of Health (DOH) has until October 30, 2026, to commit the rest.
If Year 1 showed us anything, it’s that Alaska stays on top of things. The next opportunity is already open. Year 2 fall application window runs September 30 through October 28, and the state plans to award about $75 million in this cycle ahead of CMS announcing Year 2 state awards by October 31. This round puts more weight on well-justified budgets, with a new cost-effectiveness scoring criterion and a Pay for Value Readiness focus area.
Hospitals that know their own data are well positioned.
Alaska’s Rural Health Transformation Program Strategy
Alaska’s plan centers on helping rural Alaskans get care closer to home, in a state where many communities are reachable only by plane or boat. The state expects roughly $1.3 billion over the program’s five years, with CMS setting each year’s award based on Alaska’s progress.
Every RHTP project in Alaska has to fit at least one of the state’s six initiatives:
- Healthy Beginnings: supports healthy pregnancies and early childhood
- Health Care Access: brings more services closer to home, from pharmacy to behavioral health
- Healthy Communities: invests in prevention and everyday wellness
- Pay for Value (Fiscal Sustainability): helps providers stay financially stable and get ready for value-based care
- Strengthen Workforce: grows and keeps Alaska’s health care workforce
- Spark Technology and Innovation: expands telehealth and modernizes digital tools
Every funded project also needs a plan to keep running after RHTP ends. For hospitals, that makes this a good time to think past the grant period: which new services or systems can pay for themselves in year six?
Alaska's RHTP Year 1 Awards by the Numbers
Since August 7, Fridays have become award day in Alaska. The state has released seven rounds so far, totaling more than $240 million.
Weekly award rounds
Round | Date | Awards | Projects |
1 | Aug 7 | $4.5M | 19 |
2 | Aug 14 | $30.1M | 37 |
3 | Aug 21 | $130M | 104 |
4 | Aug 28 | $15.2M | 23 |
5 | Sept 4 | $25.4M | 32 |
6 | Sept 18 | $30.2M | 27 |
7 | Sept 25 | $6.9M | 7 |
The August 21 round carried most of the weight, with $130 million spread across 104 projects.
(The state is still finalizing subaward budgets, so expect small adjustments to these figures.) Source: Alaska DOH Year 1 Funding Cycle Update
Where the 2026 RHTP money went
Initiative | Awarded | Share |
Health Care Access | $95.4M | 39% |
Spark Technology and Innovation | $43.2M | 18% |
Pay for Value | $31.5M | 13% |
Strengthen Workforce | $30.1M | 12% |
Healthy Communities | $21.5M | 9% |
Healthy Beginnings | $20.9M | 9% |
Health Care Access took the biggest share by far, and much of it pays for community-delivered care. As the Alaska Beacon reported, the Alaska Native Tribal Health Consortium received $4.8 million to expand pharmacy care. Chugachmiut is putting more than $600,000 toward a portable X-ray machine for its clinics.
For hospital finance leaders, Pay for Value is the category to watch because it funds work that prepares providers for value-based care. Small hospitals are getting attention, too. The Alaska Hospital & Healthcare Association received $249,200 to study and improve efficiencies at the critical access hospitals in Petersburg, Cordova, and Homer.
Demand far outpaced available funding
Interest in Year 1 was enormous. In the first step of the application process, 864 organizations sent DOH nearly 1,800 letters of interest, which were short project proposals. From that pool, the state invited 403 projects to submit full applications and preliminarily approved another 28 for planning grants, which fund early design work for projects that aren’t ready to launch yet.
With so much need on the table, the state used Year 1 to help organizations stabilize first. Health Commissioner Heidi Hedberg told the Anchorage Daily News that the first year was “intended to be a stabilizer,” since many applicants said they needed solid footing before taking on bigger changes. Year 2 builds from that foundation.
Year 1 deadlines
Alaska has until October 30, 2026, to commit its remaining Year 1 funds. All Year 1 funds must then be spent by September 30, 2027, and any remaining funds are subject to federal recapture.
Alaska Department of Health’s full list of awarded projects (Excel sheet)→
Alaska RHTP Year 2 Fall 2026 Funding Cycle
Applications opened September 30 and close October 28 at 11:59 p.m. Alaska time, with about $75 million available this fall and a second Year 2 cycle expected in spring 2027. Awards from the fall cycle can start as early as January 1, 2027. (The full timeline is in the Key Dates table below.)
The Alaska Community Foundation (ACF) runs the application portal on the state’s behalf. DOH and ACF held a walkthrough of the updated portal on October 1, and they will post the recording on the state’s applicant page.
Three focus areas
The fall cycle includes an open call for projects under any of Alaska’s six initiatives, plus three statewide priorities. The state chose them based on input from regional meetings across Alaska and the priorities in its RHTP plan.
- Emergency medical services. Projects that strengthen EMS and emergency response.
- Care coordination. Projects that smooth handoffs when patients leave the hospital, including transitions to other care settings and post-discharge follow-up.
- Pay for Value Readiness. Projects that help organizations prepare for value-based payment and population health management.
Focus area and open call applications compete on equal footing. Instead of scoring priority, the state plans to set a target funding amount for each focus area. Those targets may shift depending on how many strong applications come in.
What's different from Year 1
Most of the changes make applying easier:
- No letter of interest step. Organizations apply directly.
- One-time registration. Organizations register separately from their project applications, so they don’t re-enter the same details for every project.
- A five-application limit per organization. Health systems with facilities in different communities can submit five per facility, as long as each facility has its own organizational profile.
- Resubmissions are allowed. Deferred Year 1 proposals can come back, though they count toward the five.
What's held for spring
If you’re a Year 1 awardee hoping to extend your project, or you’re planning a facility renovation, hold that application for the Spring 2027 cycle. The fall round won’t accept either one. It does offer some funding to replace equipment, so an aging piece of equipment doesn’t have to wait.
That split is useful for planning. A hospital planning a remodel or other facility renovation should aim for spring, while a project built around a new service or system can apply now.
How Alaska Is Changing Its Application Scoring
Alaska is also refining how it scores applications and wants input before finalizing anything. On September 25, DOH posted three draft evaluation frameworks for public comment. One covers implementation projects, and one covers planning projects, which now get their own framework for the first time. The third covers portfolio review, the stage where DOH leadership looks at how strong projects fit together across the state.
DOH’s summary of changes lists nine updates. These four will matter most to applicants.
Budgets get their own score. A new Cost-Effectiveness and Budget Justification criterion, worth 10% of the total, assesses whether the requested amount makes sense for the work and the communities it serves. To make room, Alignment drops from 20% to 15%, and Outcomes drops from 15% to 10%.
The bar to advance is more forgiving. In Year 1, a proposal had to score at least 3.0 in every single criterion to move forward, so one low score could knock it out. The draft looks at the overall picture instead: a 3.0 weighted average across all criteria, as long as none falls below 2.5. A strong proposal with one weaker section now has room to advance.
Partnerships can take different shapes. Community Alignment and Partnerships replaces the old Strength of Partnerships and Coordination criterion, at the same 10% weight. Some projects need formal partners and others don’t, so applicants can show community support in whatever way fits their project.
A fixable budget line stays fixable. If one cost isn’t allowed but can be removed without changing the project, the state can clarify the budget instead of lowering the score.
What This Means for Rural Hospital Finance Teams
Rural hospital finance teams already defend every line of their budgets. Year 2’s scoring puts that habit on paper and gives it real weight.
Your own numbers are your strongest evidence
The new cost-effectiveness criterion asks whether a request is reasonable for the work proposed and the communities served. The most convincing answer comes from the hospital’s own data. A budget built on actual patient volumes and current costs looks very different from one based on estimates, and that’s exactly the evidence the new criterion asks for.
The sustainability plan works the same way. The state wants to know what keeps a new service running after RHTP funding ends; that usually comes down to whether the hospital can bill for it and get paid reliably. That means the chargemaster is set up correctly from day one and claims are going out clean.
Pay for value starts with a clear baseline
Value-based arrangements pay for outcomes, but a hospital can only plan for them once it knows where it stands today: what its current contracts actually pay, and how much revenue it loses to denials. That baseline work is a good fit for a Pay for Value Readiness proposal. It’s also worth doing whether or not an application gets funded.
Revenue cycle capacity can be part of the project
The state’s applicant FAQ lists building billing and revenue cycle management capacity, for organizations that don’t have it yet, as a potentially allowable use of RHTP funds. The cost has to be directly tied to the proposed project, and routine overhead doesn’t qualify. For a hospital launching a new service, pairing it with the billing infrastructure needed to sustain it can strengthen the proposal.
Key Dates to Watch
Date | What happens |
October 9, 2026 | Public comments due on the draft scoring frameworks (5:00 p.m. Alaska time) |
Mid-October 2026 | Final scoring frameworks posted |
October 28, 2026 | Year 2 fall applications close (11:59 p.m. Alaska time) |
October 30, 2026 | Deadline for Alaska to commit its remaining Year 1 funds |
By October 31, 2026 | CMS announces Year 2 state awards |
November to December 2026 | State review and applicant clarification |
December 2026 | Fall cycle notifications begin |
January 1, 2027 | Earliest start date for fall awards |
Early spring 2027 | Spring application cycle opens |
July 2027 | Earliest start date for spring awards |
September 30, 2027 | Deadline for all Year 1 funds to be spent |
Looking Ahead
Alaska spent Year 1 getting money out to a wide range of communities, and roughly 250 projects are now moving forward because of it. Year 2 builds on that with a sharper focus, including a direct look at budgets and dedicated funding targets for priorities like emergency services and value-based payment readiness.
That shift plays to rural hospital teams’ strengths. The people running these organizations already know their communities and what it really costs to keep a service going. A proposal that puts that knowledge into numbers is exactly what the new scoring is built to reward.
We’ll update this post when CMS announces Alaska’s Year 2 award and as the fall cycle moves forward.
If your team is preparing a Year 2 application and wants help pulling together the revenue and cost data behind it, reach out to our team. REDi Health works exclusively with rural and community hospitals, and we do this kind of work every day.
