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Alaska Department of Health hosted a multi-day event on Rural Health Transformation Program (RHTP) funding. In-person convening was held at the Hilton Anchorage on Thursday, Jan. 15, 2026. (Bill Roth \/ ADN) <\/p>\nAlaska Department of Health hosted a multi-day event on Rural Health Transformation Program (RHTP) funding. In-person convening was held at the Hilton Anchorage on Thursday, Jan. 15, 2026. (Bill Roth \/ ADN) <\/p>\n
This story was produced through the USC Center for Health Journalism\u2019s 2026 National Fellowship.<\/p>\n
Alaska health officials on Friday approved spending just $4.5 million of the state\u2019s $272 million allocation from the Rural Health Transformation Program, weeks after missing their own deadline to award the money.<\/p>\n
Friday\u2019s awards<\/a> account for less than 2% of Alaska\u2019s first-year allocation. More than $267 million of the funding is still awaiting final approval, with hundreds of applicants \u2014 including hospitals, clinics, local governments and Alaska Native organizations \u2014 yet to find out if they will receive a share. <\/p>\n The slow rollout leaves providers with only weeks to obligate the funding before an October federal deadline, raising concerns that Alaska could struggle to fully capitalize on a newly created federal program.<\/p>\n Department of Health leaders, who initially said awards would be finalized by mid-July, said Friday that they would announce additional awards \u201ceach Friday as they are finalized.\u201d<\/p>\n Explaining the delay in finalizing awards, Department of Health spokesperson Mirna Estrada said many applications needed additional clarification on budgets, project scope and implementation plans. She also said the Centers for Medicare and Medicaid Services has continued issuing guidance during the review process, requiring the department to adjust its evaluation.<\/p>\n \u201cThat anticipated timeline has been extended to mid-August due to emerging factors,\u201d Estrada wrote late last month.<\/p>\n The $50 billion Rural Health Transformation Program was designed to award $10 billion per year for five years across all 50 states. Alaska is set to disproportionately benefit thanks to a formula that divides a sizable portion of the funds equally among states, regardless of their population size, giving states with smaller populations larger per-capita allotments. <\/p>\n Though the Rural Health Transformation Program is intended to help the most remote communities in the country, applicants from every part of Alaska were eligible for the funding, since providers in the state\u2019s urban hubs also serve residents of rural areas. <\/p>\n The first round of funding was divided among 19 projects, with an average award size of $241,000. Several recipients were approved for more than one project.<\/p>\n Some awards went to Anchorage-based recipients that serve a statewide population; other awards are intended to serve residents of specific communities, including in the Matanuska-Susitna region and the Kenai Peninsula.<\/p>\n No projects serving several regions \u2014 including Kodiak, the Yukon-Kuskokwim Delta and the North Slope \u2014 were included in Friday\u2019s awards.<\/p>\n Health Commissioner Heidi Hedberg called the awards \u201ca long-term investment in healthier communities across Alaska.\u201d<\/p>\n \u201cThroughout this process, we\u2019ve heard directly from communities about the challenges they face and the solutions they believe will make the greatest difference. The selected projects reflect those local priorities while helping build a stronger, more sustainable health care system for future generations,\u201d Hedberg said in a statement. <\/p>\n The first round of awards comes after Alaska health officials identified more than 200 finalists in June<\/a>, including health clinics, hospitals, tribes, local governments and other entities that could get a share of the funding. The department narrowed down those possible recipients after receiving around 1,800 applications.<\/p>\n Jared Kosin, president of the Alaska Hospital and Healthcare Association \u2014 which received funding from the program in the first round of awards \u2014 said in an interview that the still-evolving requirements from the federal agency overseeing the program are largely responsible for the delay in issuing awards.<\/p>\n \u201cThe fundamental flaw continues to come from the design of the program,\u201d Kosin said, adding that it puts a burden on state officials administering the program. \u201cI don\u2019t think it was intentional, necessarily, but I really do think in many ways they\u2019re being set up to fail.\u201d<\/p>\n \u201cIt\u2019s a great opportunity for Alaska, but man, it\u2019s going to be challenging to pull this off,\u201d Kosin added. \u201cAnd I just really hope that the state agency is not the one left saddled with blame, as this becomes more and more challenging, as that pressure builds on this shrinking window of time.\u201d<\/p>\n The projects approved so far highlight the kinds of investments the state hopes the program will support.<\/p>\n Spencer Perry, an economist at the University of Alaska Anchorage\u2019s Institute of Social and Economic Research, is among the hundreds of applicants still awaiting a decision. His team has proposed studying Alaska\u2019s specialty-care landscape to identify ways to lower costs and improve access.<\/p>\n Federal program managers are \u201cencouraging this money to be spent on things that are trying to take advantage of new technologies to reform the health systems and increase access to care and quality of care,\u201d Perry said in an interview. \u201cThe deep focus on technology might kind of miss some of the lower-hanging fruit and more bread-and-butter public health healthcare access policy that we might explore.\u201d<\/p>\n Even if Alaska succeeds in spending the money, some health policy experts question whether the program can offset broader changes to the healthcare system, amid a decline in health insurance enrollment<\/a> and cuts to Medicaid, which covers the cost of care for one in three Alaskans. <\/p>\n The same bill that created the Rural Health Transformation Program also enacted substantial changes to Medicaid, a health insurance program serving low-income Americans. Nationwide, cuts to Medicaid are expected to eclipse the funding available through the rural health program.<\/p>\n