The fiscal 2027 award will support Iowa’s plans for rural cancer care, telehealth, medical equipment and workforce development. Healthy Hometowns is not a direct cash assistance program for residents.
Iowa was awarded $216,007,657.32 in federal funding for the second year of Healthy Hometowns, its Rural Health Transformation Program. The Centers for Medicare & Medicaid Services (CMS) announced the award on Nov. 9, 2026, for projects intended to strengthen health care services in rural Iowa.
The award is $6,967,593.61 more than Iowa received in the first year, when the state was allocated $209,040,063.71. The new allocation covers federal fiscal year 2027 and is part of a five-year, $50 billion program running from fiscal 2026 through fiscal 2030.
CMS awarded $10 billion across all 50 states for the program’s second year. The amount awarded to Iowa does not establish how much has already been disbursed to individual providers or spent on specific projects.
Five Healthy Hometowns initiatives target rural health care services
The Iowa Department of Health and Human Services (Iowa HHS) will continue implementing five initiatives through partnerships involving rural hospitals, health systems and community organizations:
- Hometown Connections: Expanding Centers of Excellence and regional networks connecting hospitals and clinics. Planned investments include telehealth, specialized medical equipment, workforce recruitment and limited funding to support care for uninsured Iowans.
- Combat Cancer – Prevent and Treat: Expanding cancer screening, diagnostic services and treatment through regional networks, equipment upgrades and prevention programs.
- Communities of Care: Bringing different types of health care providers into shared locations and improving coordination through community health workers and chronic disease management programs.
- Health Information Exchange: Improving electronic access to patient health records across participating providers to support continuity of care.
- EMS Community Care Mobile: Developing mobile health services and telehealth capabilities for high-risk maternal and newborn transport, along with care delivered in homes or other accessible community locations.
The regional approach links larger medical centers and specialized providers with smaller rural facilities. Projects are intended to expand access to services closer to patients’ homes while coordinating care that requires specialized resources.
Iowa reported 44 advanced procedures and expanded telehealth in Year 1
In an Oct. 9 progress report, Iowa HHS said it had obligated the full $209,040,063.71 first-year award to program activities. Obligating funds means committing them to approved purposes; it does not necessarily mean that every dollar has already been spent.
Among the first-year results reported by Iowa HHS were seven major medical equipment installations supporting 44 advanced medical procedures, including robotic-assisted orthopedic surgery.
The state also established a maternal-fetal medicine telehealth network that served 27 rural patients during its first two weeks. Cancer prevention efforts included 96 telehealth tablets deployed across 65 counties and three new rural cancer prevention specialists.
More than 100 health care facilities were connected to updated health information exchange tools, while recruitment efforts expanded services in pediatrics, psychiatry, obstetrics and gynecology, primary care and family medicine in multiple rural communities.
These figures describe results reported under the first-year award, not projects already completed with the newly announced second-year funding.
The $216 million award does not include a new hospital-by-hospital breakdown
The Nov. 9 announcement confirmed Iowa’s second-year federal allocation but did not provide a complete distribution of that amount by hospital, clinic or county.
Healthy Hometowns funds support approved state projects and participating health care organizations. The statewide allocation does not mean every rural hospital will receive an equal share, or that every proposed service is already available.
Iowa HHS maintains a public Healthy Hometowns program page with funding dashboards, project information and links to state funding opportunities and award notices.
The Nov. 9 announcement did not establish a new cash assistance application process for households or a payment schedule for individual hospitals. Separate funding opportunities and award notices are published through the state program’s existing channels.
Related: Iowa seeks federal funding to support rural health care, Gov. Kim Reynolds announces
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