North Carolina Rural Health Innovation Fund: What Providers Need to Know

North Carolina is launching a major new investment to help rural health care providers modernize technology, improve connectivity, and expand access to care. The Rural Health Innovation Fund (RHIF) will provide approximately $20 million each year for up to five years through the NC Rural Health Transformation Program.

The following overview is based on the Rural Health Innovation Fund webinar presented by the North Carolina Department of Health and Human Services and the North Carolina Department of Information Technology on September 23, 2026.

What is the Rural Health Innovation Fund?

RHIF is designed as a kickstart investment for rural health care organizations. Funding can support planning, purchasing, implementation, and testing of technology that strengthens operations and improves services for rural patients.

Who may apply?

Year 1, Round 1 eligibility is focused on health care organizations that meet the applicable North Carolina definition and serve patients who reside in rural areas. Examples include:

• Primary care providers

• Federally Qualified Health Centers and FQHC look-alikes

• Community health centers

• Safety-net providers

• Hospitals

Five technology investment tiers

Applicants will be assessed and placed into a funding tier based on their technology readiness and needs:

• Foundational Technologies: $0–$50,000 for core infrastructure such as hardware, internet equipment, productivity tools, and scheduling software.

• Baseline EHR: $0–$200,000 for acquiring or upgrading to a certified electronic health record that can connect to NC HealthConnex.

• Interoperability: $0–$140,000 for FHIR APIs, health information exchange connectivity, and USCDI data upgrades.

• AI Clinical Decision Support: $0–$200,000 for AI scribing, clinical decision support, summarization, and AI-enabled revenue cycle tools.

• Emerging Technologies: $0–$250,000 for remote patient monitoring, telehealth, predictive analytics, and population health AI.

What can funding support?

RHIF funds may help providers assess their technology needs, evaluate and procure solutions, upgrade electronic health records and business systems, expand telehealth and e-consults, strengthen cybersecurity, implement remote patient monitoring, and pilot promising AI or clinical decision-support tools.

Because the implementation window is short and funding is reimbursement-based, applicants are strongly encouraged to pursue turnkey or shovel-ready projects. The expected implementation timeline is approximately six months.

Application process and key dates

The process begins with a scored intake assessment that helps determine readiness, eligibility to proceed, and the appropriate funding tier. Eligible providers then receive technical assistance before submitting a narrative application through the NCDIT Grant Portal.

• September 30, 2026: Intake assessment opens and RHIF launches

• October 15, 2026: Application opens

• October 31, 2026: Intake assessment closes

• November 16, 2026 at 11:59 p.m.: Application closes

• January 2027: Awards anticipated

• July 30, 2027: Year 1, Round 1 activities completed

• February 15, 2027: Year 1, Round 2 application cycle opens

How applications will be evaluated

Reviewers will consider the clarity of the applicant’s need, alignment with RHIF goals, anticipated local and statewide impact, existing internal resources, preparation for barriers and risks, and the organization’s plan to sustain the investment over time.

Learn more

Providers should visit ncdhhs.gov/rhtp for updates, sign up for the NC Rural Health Transformation Program newsletter, and send questions to RHIF@nc.gov.

Disclosure: This presentation is supported by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $213,008,356.47 in budget period 1, with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CMS/HHS or the U.S. Government.