HarperRHTP Tracker
All States/North Carolina

North Carolina

Draft Released

Quality & Outcomes

FY26 Award
$/Rural Resident
$72
Rank
10th /50
Rural Pop.

Data:CMS·KFF·Census

Funding Breakdown

Baseline
Workload
Baseline: $100.0M
Workload: $113.0M

Source: KFF funding formula analysis

Initiatives by CMS Goal Bucket

Access to Care
NC ROOTS Hubs

Establish locally governed community networks (Rural Organizations Orchestrating Transformation for Sustainability) connecting medical, behavioral, and social services with AI-powered coordination.

Workforce Development
Modernize Rural Health Workforce

Build training centers, expand fellowships, and create new certifications to modernize the rural workforce pipeline.

Financial Sustainability
Advance Value-Based Payment

Build rural primary care capabilities for value-based payment models to ensure long-term financial sustainability.

Quality & Health Outcomes
Prevention, Screening, and Chronic Disease

Deploy Food as Medicine, diabetes/hypertension management, cancer screening, and perinatal care programs.

Behavioral Health and SUD Expansion

Expand CCBHCs and non-traditional workforce models for behavioral health and substance use disorder services.

Infrastructure & Technology
Accelerate Technological Innovation

Advance health information exchange, digital literacy, and AI-based clinical decision support across rural providers.

Source: CMS state abstracts

How to Participate in North Carolina

Steps for healthcare organizations to access RHTP funding through North Carolina's programs.

Lead State Agency
North Carolina Department of Health and Human Services (NCDHHS)
Visit agency website
Identify Your Role
Determine if your organization is eligible: hospitals, clinics, community health centers, health plans, and other rural healthcare providers can participate through state sub-awards.
Review State Plans
Read your state's RHTP application and initiative plans to understand which programs align with your organization's services and needs.
Engage With Your State Agency
Contact the lead state agency managing RHTP implementation. Attend stakeholder sessions and register for procurement notifications.
Respond to RFPs
When your state releases Requests for Proposals for RHTP sub-awards, submit applications aligned with the CMS goal buckets your state prioritizes.
Prepare for Compliance
Set up systems for quarterly reporting, outcome metric tracking, and financial audits required by CMS. Organizations receiving $750K+ need single audit capability.

Note: RHTP funds flow from CMS to state agencies, which then distribute to providers through sub-awards and contracts. Direct federal applications are not accepted — participation is through your state's program.

RHTP Compliance Checklist

Key obligations for organizations participating in North Carolina's RHTP programs.

0 of 8 checkedSource: RHTP NOFO

Need help navigating North Carolina's RHTP compliance?

Harper automates quarterly reporting, outcome metrics, and real-time compliance monitoring for RHTP participants. Get set up before your state's deadlines.

85 of 100
counties are rural
Nearly 3 million rural North Carolinians live across 85 of 100 counties, served by NC ROOTS Hubs connecting medical, behavioral, and social services.
Source:CMS·KFF·Census

Federal Health Funding

Total HRSA grants to this state (FY16–25) vs. new CMS RHTP award

$233.5M
$245.5M
$257.1M
$273.4M
$334.7M
$471.0M
$290.2M
$335.7M
$307.8M
$294.1M
RHTP $213.0MHRSA $294.1M
2016
2025
FY26
HRSA
HRSA (proj.)
RHTP (CMS)
HRSA 10-yr avg.
HRSA FY25 (proj. FY26)
+ RHTP FY26 award
FY26 combined$507.1M

FY26 HRSA projected from FY25 actuals (FY26 not yet published). RHTP is new CMS funding in addition to existing HRSA grants.

Rural pop. (2020)
Change since 2010
Rural poverty rate
Primary care shortage areas
Practitioners needed
Hospital closures since 2005
Complete closures
Converted (limited services)
Sources:HRSA·Sheps Center·Census·USDA ERS·HRSA HPSA

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