North Carolina Launches ROOTS Hub Lead Opportunity Under Rural Health Transformation Program

North Carolina has released a Request for Applications (RFA) for organizations to serve as NC ROOTS Hub Leads under the North Carolina Rural Health Transformation Program (NCRHTP). This opportunity represents a major statewide investment aimed at transforming rural healthcare delivery systems, strengthening regional partnerships, and improving health outcomes for nearly 3 million rural North Carolinians.

The initiative is led by the North Carolina Department of Health and Human Services (NCDHHS) and supported through federal funding authorized under H.R. 1. The program focuses on long-term system transformation through coordinated regional leadership, infrastructure development, and innovative care models.

NC ROOTS Hub Lead Opportunity

NC ROOTS (Rural Organizations Orchestrating Transformation for Sustainability) Hubs will function as regional implementation networks, coordinating partners and leading transformation activities tailored to local community needs.

Up to six organizations will be selected, with one Hub Lead designated for each North Carolina Medicaid region.

Selected Hub Leads will serve as both the programmatic and fiduciary lead, responsible for guiding regional partner networks and implementing NCRHTP initiatives across multiple focus areas, including:

• Primary care transformation

• Behavioral health integration

• Workforce development and sustainability

• Value-based payment advancement

• Digital health and technology modernization

Each Hub will work collaboratively with community partners to design and implement region-specific strategies that strengthen access, coordination, and quality of care in rural communities.

Eligibility and Applicant Expectations

Organizations applying to serve as ROOTS Hub Leads must demonstrate:

• Strong organizational infrastructure and governance capacity

• Experience managing complex healthcare initiatives

• Financial and fiduciary oversight capability

• Regional partnership and network leadership experience

• Operational readiness to coordinate large-scale implementation efforts

Applicants will be expected to lead collaborative networks and ensure the successful execution of program goals across their designated region.

Program Background and Timeline

The Rural Health Transformation Program provides one-time federal funding to help states strengthen rural healthcare through innovation, infrastructure investment, workforce development, and system redesign.

North Carolina’s program is supported by $213,008,356.47 in federal funding, highlighting the scale of this statewide transformation effort.

Application Deadline: April 2, 2026 at 5:00 p.m. EST.
Applicants should review the full RFA materials, budget worksheets, and informational webinar provided by NCDHHS before applying.

Preparing to Apply

The ROOTS Hub Lead opportunity is not a traditional grant. Selected organizations will serve as regional leaders responsible for coordinating partners and implementing long-term healthcare transformation strategies.

Strong applicants will demonstrate:

• Regional leadership and coordination capacity

• Healthcare transformation experience

• Data and performance management capability

• Partnership and stakeholder engagement strength

• Long-term sustainability planning

Burrows Consulting, now part of VMG Health, supports organizations from opportunity evaluation through proposal development and submission, helping applicants align with state priorities and present competitive applications. Reach out today!