Congress’ most recent budget reconciliation bill included controversial cuts to Medicaid spending. The legislation slashed hundreds of billions of dollars from the program over the next decade, a move that is likely to disproportionately affect rural hospitals and safety-net providers.
To offset the cuts, lawmakers introduced the $50 billion Rural Health Transformation Program (RHTP), a five-year initiative (2026-30) meant to help rural providers adapt and innovate. The goal of the funding is not to replace lost federal dollars, but to catalyze sustainable transformation: supporting new access points, care models, and technologies that promote prevention, efficiency, and resilience in rural systems.
That framing makes RHTP a critical, time-sensitive opportunity for maternal health innovation — especially in addressing hypertensive disorders of pregnancy (HDP), one of the most preventable drivers of maternal morbidity and mortality.
Why Rural Health Transformation Must Include Maternal Health
Rural communities are among the hardest places in America to give birth. More than half of all rural counties lack hospital-based obstetric services, and many face persistent shortages of obstetricians, midwives, and nurses. Expectant mothers often travel hours for care or skip prenatal appointments altogether due to cost, distance, or lack of transportation.
The results are predictable and tragic: higher rates of pregnancy complications, emergency deliveries, and maternal death. Hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension, affect nearly 15 percent of pregnancies and are among the leading causes of maternal mortality in the U.S. They are also highly preventable with consistent blood pressure monitoring and timely intervention.
Under the traditional prenatal care model, women attend just 12 to 14 visits across the entire pregnancy. For those in rural areas, even that schedule is often unrealistic. Critical warning signs of preeclampsia can emerge in the days and weeks between appointments, leaving care teams unaware of risk until it becomes an emergency. That’s where remote patient monitoring (RPM) can transform care.
RPM: a Proven, Practical Solution for Rural Maternity Care
RPM was designed to close this gap. Through a connected blood pressure cuff and digital platform, pregnant patients can measure and transmit blood pressure readings daily from home. Providers and care managers receive real-time data alerts when readings are outside the safe range — often catching potential complications before they escalate.
This continuous line of sight can be life-saving, especially for patients in rural or underserved areas who might not be able to attend frequent in-person visits.
The Rural Health Transformation Program outlines five overarching strategic goals. Four out of the five align closely with what maternal RPM already achieves in practice.
1. Make rural America healthy again: Support rural health innovations and new access points to promote preventive health and address root causes of disease.
2. Sustainable access – Help rural providers become long-term access points for care by improving efficiency and sustainability.
3. Innovative care – Spark new care models that improve quality and lower costs, incentivizing value over volume.
4. Tech innovation – Foster technologies that promote efficient, secure care delivery and digital access.
In other words, maternal RPM is a turnkey example of what RHTP was built to fund.
How RHTP Funds Can Be Used
States must allocate RHTP dollars to at least three of the approved categories, which include:
- Promoting evidence-based interventions to improve prevention and chronic disease management
- Consumer-facing, technology-driven solutions for chronic disease prevention and management
- Training and technical assistance for technology adoption in rural hospitals
- Recruiting and retaining workforce talent to rural areas
- Providing IT infrastructure and cybersecurity improvements
- Developing innovative models of care such as value-based arrangements
Maternal RPM fits squarely across these categories. States can justify its inclusion as both an evidence-based intervention and a technology-enabled care model that improves outcomes and reduces cost. RHTP funding could support technology deployment, provider training, and care manager infrastructure to sustain engagement and continuity.
The Fine Print: Unallowable Costs and Reimbursement Gaps
One important caveat: RHTP funds cannot replace reimbursement for clinical services that are already billable through insurance. CMS is clear that the program cannot be used to duplicate existing payments or inflate fee schedules.
That’s a challenge for RPM, because while the CPT codes for remote monitoring exist, reimbursement rates vary widely. In many states, reimbursement rates are so low as to make RPM practically unsustainable.
This misalignment threatens to exclude exactly the kind of digital interventions RHTP aims to promote. Policymakers and applicants will need to make a compelling case that RPM fills a gap in coverage or represents an essential transformation in care delivery. Demonstrating that maternal RPM serves populations with limited reimbursement pathways—such as uninsured, Medicaid, or geographically isolated patients—can help justify its inclusion.
Ultimately, the sustainability of any RHTP-funded project will hinge on whether these innovations can transition into standard reimbursable practice through partnerships with Medicaid and commercial payers.
A Five-Year Window for Lasting Change
The RHTP’s $50 billion fund is spread over five years, while the Medicaid cuts it was designed to offset are permanent. That imbalance underscores the urgency of using these dollars strategically — not to patch holes, but to reimagine the delivery model itself.
If used wisely, the RHTP could catalyze a generational shift in how rural America delivers care — particularly for women and families. By investing in scalable, evidence-based solutions like maternal RPM, states can not only save lives in the short term but also build the infrastructure for long-term health system sustainability.
About Anish Sebastian
Anish Sebastian co-founded Babyscripts in 2014 with the vision that internet-enabled medical devices and big data would transform the delivery of pregnancy care. Since the company’s inception, they have raised more than $40 million. As the CEO of Babyscripts, Anish has focused his efforts on product and software development, as well as research validation of their product.
