Despite higher rates of chronic disease in rural areas vs. their urban counterparts, rural America's health care infrastructure is collapsing. Since 2010, about 150 rural hospitals have closed or been converted to other facilities, and fewer than 4 in 10 rural hospital beds are typically occupied – substantially less than urban areas.

Rather than repeating the mistakes of the past, President Donald Trump's administration will deliver unprecedented investments to rebuild rural health care infrastructure and address the root causes of the health care crisis facing rural America.

The status quo has failed rural patients. The human cost is devastating: worse health outcomes, longer travel times for care and entire communities losing their health care lifelines. Throwing money at struggling hospital operations is like a Band-Aid on a severed artery, leaving a broken system in place.

In the Working Families Tax Cut Act, Congress created the Rural Health Transformation (RHT) Program to address the underlying problems that cause rural health care to fail. President Trump and congressional lawmakers have entrusted us with stewardship of $50 billion to transform rural health care delivery across all 50 states.

On Sept. 15, we’re announcing the application for which states can apply to receive these funds.

We recently previewed guiding principles to implement the program at the bipartisan National Governors Association meeting in Colorado. Unlike previous efforts that merely sustained the status quo, this program addresses the root of the challenges rural communities face: sustainable access to better health outcomes.

Rural communities have different health care needs

We suggest governors evaluate five promising core models that are consistent with the law and could match their priorities:

  • Sustainable alliances are a foundation to strengthening rural health care facilities. This approach will support rural providers in developing innovative operating models – building scale with other providers to better meet the needs of the communities they serve.
  • Technological innovation can also be part of the solution. Imagine a patient checking symptoms on an iPhone at any hour of the day instead of driving 35 miles to see a doctor, or a provider replacing bulky filing cabinets with an AI-powered, cloud-based system that cuts administrative work in half. These kinds of tools reduce barriers to care and free up time and resources for patients.
  • States can also launch bold initiatives aimed at improving lifestyle choices, which are the root causes of chronic diseases that drive more than half of our nation’s health care costs. If we are serious about Making Rural America Healthy Again, physical activity, proper nutrition and prevention must be prioritized.
  • RHT can also be used to tackle workforce challenges head-on. Recruiting and retaining health care workers where they are needed most is critical, and states could consider allowing professionals like pharmacists to take on greater roles in delivering care. States may also choose to streamline across-state licensing to promote access. Without such measures, staffing shortages will continue to compromise access in too many rural communities.
  • Finally, RHT can catalyze innovative care models that provide doctors and hospitals with the cash flow stability they need to invest in the future. By shifting incentives to reward providers for keeping patients healthy – not just treating them when they are sick – we can align resources with prevention and improved health outcomes.

Governors should think big and fight for their rural communities

Rural America deserves a health care system built for reality, not one that’s made up of urban leftovers that leave rural health care needs as an afterthought.

Put simply, the Working Families Tax Cut Act moves the Medicaid program away from a status quo that overwhelmingly benefits urban and politically connected health systems. The Centers for Medicare & Medicaid Services chief actuary estimates that only 7% of Medicaid hospital spending (inpatient and outpatient) even makes it to rural hospitals.

The Rural Health Transformation Program represents a fundamental shift from sustaining failure to building success, investing $50 billion to support rural providers. It gives states the tools and flexibility to address their specific rural health care challenges for the long run.

Rural communities, the foundation and backbone of American exceptionalism, have waited too long for Washington to act. This program offers structural ‒ not temporary ‒ fixes, and we will begin supporting those solutions by early 2026.

Now that the application process has opened, we encourage governors to think big and submit audacious proposals. We look forward to working with America’s governors to Make Rural America Healthy Again.

Robert F. Kennedy Jr. is the secretary of Health and Human Services, and Dr. Mehmet Oz serves as the administrator of the Centers for Medicare & Medicaid Services.

This article originally appeared on USA TODAY: Kennedy and Dr. Oz: Rural America's health care is collapsing. Here's how we transform it.

Reporting by Robert F. Kennedy Jr. and Dr. Mehmet Oz / USA TODAY

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