Gov. Kim Reynolds announced Wednesday the state has submitted its application for the Rural Health Transformation Program, a federal funding initiative managed by the Centers for Medicare and Medicaid Services. If Iowa’s proposal, titled Healthy Hometowns, is fully awarded, Iowa could receive $200 million per project year period, totaling $1 billion over the five-year grant.

The proposal is aimed at building a hub and spoke model system of care that improves the health, well-being and quality of life in rural Iowa communities and addresses barriers to care, according to a news release. A hub and spoke model organizes health care providers and facilities with central hubs that provide services to the smaller more geographically dispersed “spokes.”

Healthy Hometowns was developed in collaboration with rural hospitals, health systems and community partners. The initiative includes six key components: 

• Expanding Centers of Excellence and developing Health Hubs with investments in telehealth, medical equipment and care for uninsured Iowans. 
• Recruiting and retaining top-tier health professionals in rural communities through targeted incentives. 
• Prevent and Treat Cancer: Increasing access to cancer screening and treatment, forming cancer-specific hubs and supporting families and research. 
• Communities of Care: Co-locating providers for coordinated multidisciplinary care supported by community health workers. 
• Health Information Exchange: Ensuring seamless access to health records across the state to support continuity of care. 
• EMS Community Care Mobile: Bringing care directly to rural residents through mobile health services and high-risk transport support. 

Within five years, the state would anticipate measurable improvements, including: 

• Fewer emergency department visits for preventable conditions. 
• More rural residents receiving care locally. 
• Increased provider-to-population ratios. 
• Expanded telehealth access across rural Iowa. 

Rural communities face unique and growing challenges in accessing health care, according to the news release. Nearly every Iowa county with below-average health insurance coverage is rural. Rural Iowans drive an average of 30 minutes to the nearest hospital and 24 minutes to see a primary care provider. These barriers are compounded by workforce shortages, chronic disease prevalence and economic disparities. 

“Since taking office, my administration has emphasized the importance of supporting and revitalizing rural Iowa through targeted investments and policy initiatives,” Reynolds said in a prepared statement. “Rural communities are the backbone of our state — home to nearly half of all Iowans and the foundation of our economy, culture and identity. Healthy Hometowns is a pivotal opportunity to build a high quality, sustainable system of care that vastly improves health, well-being and quality of life for rural Iowans.” 

Notices of state awards are expected on Dec. 31. More information about Iowa’s Rural Health Transformation proposal, including its application, is available online.