GREAT Health Frequently Asked Questions

The Georgia Rural Enhancement And Transformation of Health (GREAT Health) Program is the name of the State of Georgia’s new Rural Health Transformation Program.

On July 4, 2025, Congress passed H.R. 1, commonly referred to as the One Big Beautiful Bill Act (Section 41401 of Public Law 119-21). This bill contains a section that creates a new, completely federally funded Rural Health Transformation Program. This is a grant program that allows states to apply once for potentially five years of funding across a variety of initiatives.

The Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding of Opportunity for the Rural Health Transformation Program on September 15, 2025. The submission deadline was November 5, 2025, before midnight. 

The Find Funding Opportunities page will be continuously updated with information for organizations who intend to apply as subgrantees for specific projects. 

Congress provided $10 billion per year for five years for the Rural Health Transformation Program. Each year, $5 billion is divided equally between all states that applied for the Rural Health Transformation Program and $5 billion is distributed based on a methodology developed by the federal government. The Program funding is for fiscal year 2026 – 2030. 

Georgia received $218.8 million dollars in Year 1 funds from CMS. Funding for future years has not yet been released. 

The initiatives of the GREAT Health Program are: 

• Transforming for a Sustainable Health System in Rural Georgia
• Strengthening the Continuum of Care in Rural Georgia
• Connecting to Care to Improve Healthcare Access in Rural Georgia
• Growing a Highly Skilled Healthcare Workforce in Rural Georgia
• Leveraging Technology for Healthcare Innovations in Rural Georgia

An “initiative” is comprised of multiple “strategies”, which, when combined, work together to achieve the intended goals above. “Strategies” are a subset of an “initiative”.

AHEAD stands for Achieving Healthcare Efficiency through Accountable Design. This is a model developed by the Centers for Medicare and Medicaid Services (CMS) for health systems to participate in value-based care. The AHEAD model as designed in the GREAT Health application will be unique to Georgia. It will require an additional application for the state to be accepted into the cohort, and there will be a planning period from 2026-2028, giving providers several years to make adjustments and learn more about the benefits of participation. More details on the AHEAD model can be found on CMS’s website.

The AHEAD model has the potential to transform the way healthcare is financed in rural Georgia. This model, and the potential funding and strategy coordinated through the AHEAD initiative in the GREAT Health Program, can bring vital health resources that rural Georgia has never had before. Instead of providers being paid when a patient is sick, this model incentivizes hospitals and providers alike to help keep patients well by paying them based on a global budget across Medicare, Medicaid, and commercial plans. This can shift the way healthcare is delivered and encourages higher quality, more comprehensive care for patients. Georgia is committed to working with rural providers to ensure they are supported and informed on the model as they embark on this change.

All Georgia counties were run through the HRSA Rural Health Grants Eligibility Analyzer, resulting in 126 eligible counties and portions of counties. All 126 eligible counties can be found on the Eligible Counties List page. The list as published for the GREAT Health Program does not change the state’s overall definition of rural or impact any current, in-progress, or future grants, applications, or initiatives of the State Office of Rural Health.

CMS has stated that the state will submit one application for all five years of funding.

DCH will release competitive funding opportunities for specifically identified strategies each year as funding is made available through CMS. For a list of the strategies that will be competitively awarded this year, please review the Find Funding Opportunities page.

There was only one application to CMS for all five years, and the state is not authorized to add any additional initiatives at this time.

Please email [email protected] with any questions.