6.1 Institutionalize the Rural Health Innovation Fund (RHIF)
Department of State Treasurer (NCDST), which oversees the State Health Plan, the Rural Health Innovation Fund (RHIF) is a catalytic investment that will help rural health providers modernize their business operations and health IT infrastructure, while testing and scaling novel digital solutions that can help future-proof rural health systems as the digital landscape evolves.
Capitalizing on the Treasury’s streamlined funding mechanisms, the program offers direct financial support to help providers assess current data systems, identify needs for new health IT, vet vendors, manage procurement and implementation, and establish effective governance for health information technology. The Fund also enables providers to pilot and adopt innovative solutions and emerging technologies, giving them the flexibility to test and integrate tools that improve care, streamline workflows, and enhance patient engagement. Key examples of supported technologies and tools include:
- Expanding telehealth and e-consult capabilities
- Selecting, optimizing, and implementing Artificial Intelligence (AI) tools, such as for clinical decision support (CDS) (see text box below)
- Upgrading electronic health records (EHRs)
- Implementing business IT platforms
- Strengthening cybersecurity
- Adopting remote patient monitoring and patient/consumer engagement tools (e.g., apps and portals)
- Piloting new and emerging technologies to advance rural health care delivery
As one of the largest health purchasers in the state, NCDST ensures that RHIF investments are not only responsive to provider needs but also scalable, sustainable, and aligned with broader efforts to improve care quality and reduce avoidable costs.
Per the NOFO, the RHIF is capped at 10% of the total CMS award $20M in any given budget period.
What works in NC: NCDST and Fund Management for Impact.
NCDST was tasked with allocating more than $100 million to communities in western North Carolina impacted by Hurricane Helene through a brand new cashflow loan program. In less than 2 months, the Department created the infrastructure needed to implement this initiative and started providing much needed cashflow relief to local governments. The NC DST and State Health Plan have the experience, mindset, and expertise needed to ensure that critical funds are sent to the right community partners and will work with DHHS to do so in an efficient manner.
Helping Rural Providers Use Artificial Intelligence (AI) for Ambient Transcription and Future Clinical Decision Support (CDS).
By equipping rural primary care providers across NV with artificial intelligence (AI)-powered ambient transcription tools. These tools reduce administrative burden by listening to patient visits and automatically generating clinical documentation, allowing providers to focus more fully on patient care.
While today’s technology primarily supports documentation, it lays the groundwork for more advanced CDS capabilities. In the near future, these systems are expected to evolve into intelligent assistants that offer real-time, evidence-based insights to support diagnosis and treatment—particularly valuable in rural settings where access to specialists and diagnostic resources may be limited. These CDS tools aim to passively deliver relevant information during the clinical encounter, helping improve care quality, reduce unnecessary testing, and strengthen provider knowledge.
Over time, the cost is expected to be offset by gains in provider productivity, improved performance on quality measures, and reduced administrative staffing needs. As value-based payment models expand (see Initiative 5), these tools will also support care gap closure and quality bonus attainment—creating a sustainable path forward.