The Rural Health Transformation (RHT) Program and its Impact on Native Health and Our Workforce

Healthy communities are built when the people who care for them never have to leave home to do it.

The Rural Health Transformation (RHT) Program, a historic $50 billion funding measure authorized by the One Big Beautiful Bill Act (OBBBA), is now one of the most consequential investments in Indian Country healthcare in a generation. For non-IHS entities serving Native populations where transportation and geographic isolation remain daily barriers, this federal capital offers a genuine path to stability.

The stakes are high: current data confirms that 66% of rural Medicare patients receive their primary care from a nurse practitioner (NP) or a physician assistant (PA), making these professionals the undisputed backbone of tribal clinical workforce on ramps. By prioritizing programs that grant full practice authority to non-physician providers—including allied health professionals, community health workers (CHWs), nurses, and physician assistants (PAs) —the RHT Program creates a sustainable primary healthcare foundation that keeps Our Relatives closer to the care they deserve!

Arizona Leads Tribal Healthcare Workforce Growth

Arizona operates as a national model for how smart regulatory policy directly strengthens Native health outcomes and protects our elders. Because Arizona grants full practice authority to non-physician providers—including allied health professionals, community health workers (CHWs), nurses, and physician assistants (PAs) —the state is projected to see a 71.1% growth in its NP workforce through 2026—the highest rate in the United States.

Facilities such as Utah Navajo Health System Inc., Dilkon Medical Center, Sage Memorial Hospital, Flagstaff Medical Center, Banner – University Medical Center, and St. Joseph’s Hospital and Medical Center depend on Native practitioners who carry both clinical expertise and deep cultural awareness into every patient encounter. Recruiting clinicians raised in these rural communities — who have a natural desire to return home and serve — is the single most effective retention strategy in Indian Country today.

CMS announced the awards last December, and Arizona received $166,988,956 in funding for FY26.

A mainstay of Arizona’s Rural Health Transformation (RHT) plan is its deliberate focus on Tribal sovereignty and health equity, moving beyond a one-size-fits-all rural strategy to specifically address the needs of the state’s 22 federally recognized Tribes. The plan explicitly integrates the Arizona Advisory Council on Indian Health Care into its governance structure, ensuring that workforce development initiatives aren’t only geographically distributed but also culturally relevant by forming dedicated clinical rotation slots in Tribal 638 facilities and Indian Health Service (IHS) clinics for Native students.

This approach lengthens funding for traditional healing models within the ‘Innovative Care’ pilots and expands mobile crisis units directly onto Tribal lands. By directing telehealth and broadband investments to the most remote reservation communities and decreasing administrative burdens for Tribal health authorities, the RHT aims to build a health infrastructure that upholds Tribal jurisdiction while closing the persistent gap in outcomes for Native American families.

Make Rural America Healthy Again: Arizona’s RHTP bolsters prevention efforts, advances early interventions, expands behavioral health and maternal-fetal health programs, and enhances support for chronic disease prevention and management through the Priority Health Initiatives Grants Portfolio. This strategy aims to increase access to health screenings, education, and care for rural communities.

Proactive Advocacy for Native Medical Staffing

As a Native-owned small business, Ellsworth is committed to being an engaged partner to every IHS facility, tribal clinic, and Native-led health system in navigating these shifting federal programs. Culturally competent staffing is not a courtesy — it is a clinical standard.

Ellsworth is ready to help your facility build a workforce that respects the heritage and health of Native populations across the Southwest. Contact Ellsworth today to ensure every elder and family member receives the highest-quality care.