What does it take to bring healthcare closer to 1.75 million rural residents? That’s the challenge South Carolina is tackling through its Rural Health Transformation Program (RHTP).
The Rural Health Transformation Program is a $50 billion federal initiative designed to strengthen rural healthcare across the United States from 2026 through 2030. South Carolina is putting its share of this funding toward addressing the challenges facing rural communities and healthcare providers.
In September, the state announced 228 grants totaling approximately $167.3 million. Those awards are part of South Carolina’s approximately $200.03 million federal fiscal year 2026 allocation.
This update takes a closer look at the challenges shaping South Carolina’s Rural Health Transformation Program and the state’s progress in putting its funding to work.
32.6% rural: What's driving South Carolina’s Rural Health Transformation Program
South Carolina’s RHTP application estimates that 1.75 million residents, or 32.6% of the population, live in rural areas. A greater chronic disease burden, fewer providers, and transportation barriers are part of that reality, and the application even cites a diabetes prevalence of 13%. The application notes these concerns and a lower number of primary care physicians per resident in rural areas compared to urban areas.
Geography plays another role in the challenges South Carolina faces. Many areas require more than a 30-minute drive, with residents of the lower midlands and coastal regions especially likely to live farther than 30 minutes away. Limitations in public transportation make it difficult for patients to receive care as well.
South Carolina’s response to these challenges is not about building from the ground up. There are already programs operating in the state, and various initiatives aim to extend these established care models into more rural communities. RHTP efforts aim to extend the state’s mobile crisis work and chronic disease initiatives.
What are South Carolina’s RHTP initiatives?
The September awards cover four of South Carolina’s five initiatives. The figures below refer to the announced awards, rather than the preliminary funding estimates published when applications opened.
Connections to Care: strengthening the systems that connect patients with providers
$58.35 million across 62 awards
Connections to Care prioritizes modernizing health information technology, expanding remote patient monitoring, and improving assistive technology. This includes supporting EHR improvements by finding more secure information-sharing methods and giving providers the tools to follow patients between visits. With these investments, South Carolina hopes to address both the geographic and practical difficulties systems face when coordinating care.
Leveling Up: extending proven care into more communities
$6.83 million across eight awards
Leveling Up has focused its first-year grants on expanding its already established chronic disease programs. South Carolina has identified a need for additional support when addressing conditions such as diabetes, hypertension, and sickle cell disease, and opportunities to address this are meant to be found through telehealth and provider/patient education. At the bottom line, Leveling Up is built to help more patients benefit from coordinated care, no matter where they live.
Wellness Within Reach: making care easier to access locally
$23.12 million across 54 awards
This initiative supports community care sites and mobile crisis response. Care sites can include permanent clinics, mobile units, and seasonal or intermittent locations to address the needs of their communities. This work also addresses awareness, helping community organizations and first responders better understand how and when people connect with existing crisis services.
Shoring Up to Sustainability: supporting the capacity to keep delivering care
$79 million across 104 awards, the largest share of the September announcement
This initiative is more distinctly positioned to address workforce recruitment and retention. First-year priorities include upgrading equipment and building systems, leveraging workforce incentives to bring in more talent, and training hospital staff in areas such as operational planning. Sustainability in the rural health workforce is a widespread issue across the United States, and these investments are part of South Carolina’s efforts to address it.
Tech Catalyst Fund: supporting technology designed for rural needs
South Carolina’s fifth initiative is run separately by the South Carolina Research Authority (SCRA). It helps early-stage medical technology companies develop tools that could improve rural healthcare access. Funding is tied to clear milestones and measurable benefits. Regular reporting is crucial for these companies to demonstrate effective use of funds.
Recent developments: awards are moving into implementation
Funding decisions and recipients are now public
On July 31, 2026, applicants received their funding decisions, followed by the public announcement on September 15. South Carolina’s Department of Health & Human Services (SCDHHS) received 712 applications before selecting the 228 funded projects through its merit-review process. The grants totaled approximately $167.3 million.
The published Year 1 award list gives hospitals and community partners a starting point for understanding which projects received support.
Planning begins for Years 2-5
SCDHHS asked for public feedback through a rural health assessment survey that ended on October 2, 2026. The survey asked for experiences with funded projects and the priorities addressed in Year 1. Implementation of this feedback will hopefully drive how the state approaches its initiatives in the coming years.
SCDHHS communications and Medicaid bulletins are another place to watch for RHTP updates and guidance. You can also subscribe for updates or contact grants@scdhhs.gov with program questions.
Finally, check SCRA’s Tech Catalyst Fund for funding opportunities focused on rural health technology. The first-round deadline was June 25, 2026, so watch the page for future opportunities.
Key Takeaways for state and rural healthcare leaders
Build reporting into the work from the beginning. South Carolina’s example agreement calls for regular project and financial updates. Set up clear measures and governance regarding reporting responsibilities so teams can easily show what was done and what results it produced.
Test the financial model early. Bring financial and revenue cycle teams into the planning process from the start. Look at staffing costs, expected patient volume, reimbursement, and what it will take to keep the service going after grant funding ends. This helps turn a funded project into something the organization can sustain long after RHTP is over.
Building something communities can count on after RHTP
With 228 projects receiving funding, making sure those investments lead to improvements that last is at the core of South Carolina’s efforts.
At REDi Health, we believe good data makes that possible. Rural healthcare organizations already have valuable information throughout their systems. When teams can bring that information together and understand what it is telling them, they have a much clearer picture of whether a project is working and where they may need to adjust.
Sustainability matters too. A new service may be funded today, but hospitals still need a way to support it when the grant period ends. That could mean finding recurring revenue through a chargemaster review or reducing preventable denials. It could also mean giving leaders better visibility into their operations so they can make more informed decisions.
If you’re thinking about how to turn RHTP funding into lasting impact, reach out to our team. We have found time and time again that understanding your data leads to lasting improvement and greater access to care for your rural community.
