Rural communities often face barriers to high-quality health care, including fewer providers, long travel times, and limited infrastructure and workforce capacity to meet physical health, behavioral health, and social care needs. The federal Rural Health Transformation Program is creating new opportunities for states to strengthen access to care and invest in rural health care innovation. Through its work, CHCS identifies practical strategies for how states and their partners can leverage Medicaid innovation to improve care delivery, strengthen access, build workforce capacity, and promote long-term sustainability in rural and frontier areas.