A conversation with Kelly Parker on the $50B Rural Health Transformation Program: why workforce is the real test, and why the leaders who succeed will start with outcomes, not dollars.
The Rural Health Transformation (RHT) Program is one of the largest federal investments rural healthcare has ever seen. Fifty billion dollars over five years, administered through states, built to move rural healthcare from short-term survival toward long-term redesign. But the size of the fund isn’t the story. What leaders do with it is.
We sat down with Kelly Parker, Vice President of External Affairs and Government Excellence at Propelus, to talk about what’s really happening on the ground in rural healthcare, why this moment matters well beyond rural communities, and the one piece of advice she’d give any leader trying to make the most of it.
Let’s start with the landscape. What’s actually happening in rural healthcare right now?
Rural healthcare leaders are operating in a constant state of pressure and adaptation. The reality on the ground is workforce shortages, financial strain, limited specialist access, and growing demand from aging, higher-acuity populations. All of this is happening at once.
At the same time, there’s a real shift underway in how states and federal partners are engaging. Programs like the Rural Health Transformation Program are signaling a move away from short-term stabilization and toward long-term system redesign. They’re giving states the tools to think more holistically about workforce, access, technology, and care models.
What’s the most acute pain point, and where’s the opportunity?
The most acute pain point right now is the workforce. Every challenge in rural healthcare ultimately traces back to people. Recruitment, retention, burnout, pipeline sustainability.
The opportunity is that states and federal partners are finally aligning around more than short-term fixes. We’re seeing real momentum around workforce pathways, telehealth expansion, regulatory modernization, and just system-level investment. That convergence creates a rare window to move from stabilization to sustainability. And it matters because demographic and workforce pressures aren’t slowing down. The decisions being made now will define access to care for the next decade.
Thinking beyond rural, why should anyone outside rural healthcare care about this?
It really is about the entire system. This isn’t just a rural issue, it’s a healthcare system issue. Rural hospitals are often the earliest indicators of broader structural stress in workforce, access, and sustainability. When rural systems struggle, that pressure shifts across the whole continuum of care, from urban emergency departments to statewide workforce pipelines.
So what’s really at stake is a simple question. Can the U.S. healthcare system ensure access to care regardless of geography? If rural healthcare doesn’t stabilize and modernize, the ripple effects will be felt everywhere. So everyone should be watching, and everyone should be engaged.
If you were advising a rural hospital CEO or a state DOH director on how to make the most of RHTP, what’s the one piece of advice you’d give?
I’d advise them to start with the outcome, not just the funding. In my opinion, the most successful leaders won’t be the ones who just focus on maximizing dollars. They’ll be the ones who clearly define what success looks like for their communities five years from now, and then build everything backward from that.
If you anchor in outcomes, whether that’s access, workforce stability, technology, or community health, you naturally align your partners and your funding strategy in a way that lasts beyond any single program or funding cycle.
So what does success actually look like?
Success is when rural healthcare is no longer in survival mode. That’s plain and simple, but there’s a little more to it. It’s really about stable access to care close to home, stronger workforce pipelines, and providers who see a long-term future in the communities they serve.
And most importantly, it’s very human. Success is when fewer families have delayed care, fewer clinicians are leaving, and rural hospitals can focus on health, not constant crisis. If RHTP succeeds, it won’t be remembered as a funding program. It’ll be remembered as the moment rural healthcare began to stabilize and rebuild.
Kelly’s point is a good compass for anyone navigating this moment. The transformation goes beyond funding, technology, or even the program itself. It’s about people. The families who need care close to home, and the clinicians who need a reason to stay.
That’s where we anchor our work too. The transformation is about people. Propelus exists to ensure the people giving the care can do so to the best of their ability, without friction.
Want to see how the Rural Health Transformation Program could reshape rural care in your state? Learn more