A $50 Billion Reset for Rural Healthcare

The Centers for Medicare & Medicaid Services (CMS) has committed $50 billion over five years (2026–203) to the Rural Health Transformation Program. Every state will receive a share, with flexibility to focus on local priorities such as:

• Workforce development and retention
• Access to maternal care and specialty services
• Technology, telehealth, and data infrastructure
• Regional partnerships and clinically integrated networks

While states are still finalizing their allocation plans, one message is already clear: leaders do not want a temporary bailout. They want long-term sustainability built on people, not just buildings.

That focus on workforce creates a major opportunity for international nurses seeking U.S. employment, particularly through digital marketplaces like NurseContact, which connect nurses directly with vetted rural employers.

Workforce: The Foundation of Rural Transformation

For many hospital executives, workforce issues are at the center of their strategy.

In Wisconsin, Osceola Medical Center CEO Kelly Macken-Marble expects the state to lean heavily into workforce, technology, and rural partnerships. While early in the process, she sees the potential for funding that supports recruitment, retention, and collaboration across sectors not just isolated one-off programs.

“We are encouraged about the opportunity, specifically in the area of technology and innovation,” she shared. “Grants for workforce and rural partnerships look to be focused on bringing together multi-sector partners.”

This kind of multi-sector collaboration is exactly the environment where international nurses can add tremendous value especially when employers are supported to create structured orientation, preceptorship, and long-term retention strategies.

In Oklahoma, the state has outlined six pillars for its Rural Health Transformation Fund, with workforce development at the core.

Tom Vasko, CEO of Newman Memorial Hospital in Shattuck, Oklahoma, sees the program as a chance to accelerate work the hospital has already started: strengthening access, improving sustainability, and maintaining quality care across a large rural service area.

Rather than seeking one large grant, Newman Memorial expects to pursue targeted funding across multiple priority areas, including:

• Telehealth and virtual care
• Preventive and primary care
• Chronic disease management
• Data and analytics infrastructure
• Health information exchange
• Workforce growth and retention

Vasko emphasizes that transformation funds would be used primarily for startup costs, infrastructure, onboarding, and capability building, with a clear pathway to long-term viability through billable services and efficiencies.

For nurses especially internationally educated nurses this matters. Hospitals investing strategically in infrastructure and workforce onboarding are more likely to:

• Offer structured orientation and residency programs
• Support nurses in adjusting to U.S. clinical practice
• Provide stable, long-term employment rather than short-term fixes

These are the types of employers often featured on NurseContact, where nurse–employer matching is designed around quality and long-term success.

Building the Talent Pipeline: “Growing Our Own” and Where International Nurses Fit In

While hospitals are working to stabilize their immediate workforce needs, academic institutions are looking further ahead.

In New Mexico, *Rebecca Napier, Vice President of Finance and Administration at the University of New Mexico Health Sciences Center, is thinking about how transformation funds can strengthen the *education pipeline for healthcare professionals.

She notes that the university trains a disproportionately large share of the state’s physicians and that providers who complete both medical school and residency locally are more likely to stay and practice in the region.

“Buildings don’t take care of patients. People do,” Napier said. “If we don’t grow our healthcare workforce, our healthcare access problem will never be solved.”

The university plans to double the number of students and graduates by 2035, supported by:

• Expanded faculty roles
• New clinical training sites
• Increased opportunities for nurses, physicians, pharmacists, and population health workers

This “grow your own” model doesn’t compete with international nurses; it complements them. As domestic pipelines scale up, rural systems will still need experienced internationally trained nurses to:

• Fill immediate gaps in critical areas
• Mentor newer graduates
• Support growth of new service lines, especially in rural and frontier communities

Platforms like NurseContact play a crucial role here by offering a streamlined hiring process for international nurses, helping U.S. employers find qualified candidates who can integrate into these evolving systems.

Napier also points out that funds may be used to expand behavioral health and addiction services, areas where nursing roles are increasingly specialized and in high demand opening additional pathways for both domestic and international nurses.

Maternal Health: A Priority with High Stakes

Nowhere is the rural access crisis more visible than in maternal health. Many rural hospitals have closed obstetrics (OB) units due to low volume and financial pressure, leaving large geographic areas without local maternity care.

In South Carolina, Carolina Pines Regional Medical Center CEO Brian Sponseller has proposed several maternal health projects in response to the state’s planning process.

“There are three counties between us and North Carolina that have no maternal care, no OB, nothing,” he noted.

Carolina Pines is proposing a family medicine residency program with an OB focus, training family physicians to provide maternity care while also serving broader primary care needs. The plan includes leveraging remote monitoring technologies so pregnant patients in rural areas can receive:

• Clinically guided home monitoring
• Fewer long-distance trips for routine appointments
• Earlier detection of complications

Such models are likely to rely heavily on nurses particularly maternal health, family practice, and community health nurses to provide education, follow-up, and monitoring.

For international nurses with obstetrics or women’s health experience, this emerging landscape presents strong career potential in rural regions. Employers investing in maternal care may increasingly turn to global nurse recruitment to staff these programs sustainably. Through NurseContact, these hospitals can directly connect with nurses who have:

• Labor and delivery experience
• Prenatal and postnatal care expertise
• Community-based maternal health backgrounds

In Oregon, Southern Coos Hospital & Health Center CEO Raymond Hino expects many rural hospitals to apply for funds specifically to sustain or restore obstetrics services.

This growing focus on maternal care means international nurses with OB experience could be especially sought after by rural hospitals over the next several years.

Regional Collaboration: Sharing Infrastructure, Sharing Talent

Another major theme emerging from state planning processes is collaboration across hospitals, regions, and sectors.

In Oregon, early plans include a phased funding model, with:

• Initial “catalyst” grants for shovel-ready projects
• Later phases supporting broader regional initiatives and shared infrastructure

Southern Coos Hospital & Health Center plans to seek startup funding to help launch an Oregon Clinically Integrated Network (CIN) involving independent rural hospitals. Much of the groundwork has already been done, with a target “go-live” date before October 1, 2026.

CINs allow hospitals to:

• Coordinate care across regions
• Standardize quality and data practices
• Share resources, including specialized staff and telehealth capabilities

For nursing, regional collaboration can mean:

• More standardized clinical protocols across facilities
• Opportunities for cross-site training and professional development
• More predictable staffing patterns and schedules
• Broader opportunities for international nurses to work within a supportive, integrated network

Oregon’s plan to administer the program through its Rural Health Coordinating Council, which includes rural hospitals, EMS, primary care, and clinics, is another sign that systems are being built with input from front-line stakeholders.

For international nurses entering through platforms like NurseContact, this shift toward integration and coordination translates into a more stable, system-level approach to workforce planning not just one-off placements.

What This Means for International Nurses and U.S. Employers

For international nurses, especially those exploring roles via NurseContact’s digital marketplace, the Rural Health Transformation Program creates several key advantages:

1. More Rural Opportunities, Better Supported

• Expanded service lines (OB, behavioral health, chronic disease management)
• Stronger onboarding and infrastructure support funded by federal dollars
• Increased use of telehealth, remote monitoring, and data systems that value tech-savvy nurses

1. Employers Investing in Long-Term Relationships

• Hospitals aren’t looking for temporary fixes; they’re planning for sustainability
• Funding is oriented toward building capacity, not just plugging gaps
• This aligns well with international nurses who seek stable, multi-year placements

1. Greater Emphasis on Training and Education

• As states invest in training pipelines and clinical education, employers will prioritize structured learning environments
• International nurses can benefit from rural facilities that are already building robust training cultures

1. Streamlined Hiring Through Digital Marketplaces

• Programs like this often increase demand faster than local pipelines can supply
• Platforms such as NurseContact help hospitals quickly connect with qualified global candidates
• Employers can leverage NurseContact’s streamlined hiring process, immigration support coordination, and candidate matching tools to build a resilient workforce efficiently

For U.S. rural employers, partnering with a digital recruitment platform centered on international nurse placement will likely become a strategic advantage as competition for talent intensifies.

Looking Ahead: Rural America as a Destination for Global Nursing Talent

As the Rural Health Transformation Program moves from planning to implementation, one thing is becoming clear: rural America is positioning itself not just to survive, but to redefine what rural healthcare can be.

Workforce, technology, maternal health, behavioral health, and regional collaboration are all rising to the top of state agendas. Each of these pillars creates new roles and career pathways for nurses many of which will be difficult to fill without tapping into the international nursing workforce.

Digital marketplaces like NurseContact sit at the intersection of this transformation:

• Connecting international nurses with high-need U.S. rural employers
• Simplifying the hiring and placement process
• Helping organizations design sustainable staffing strategies aligned with new federal funding streams

For nurses abroad considering a move to the United States, this is a pivotal moment. Rural communities are investing not only in buildings and technology, but in the people who will keep those systems running.

And for rural hospitals and health systems, aligning their workforce strategy with platforms like NurseContact could be the key to turning federal transformation dollars into real, lasting change staffed by a globally diverse, highly skilled nursing workforce.