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 invest in rural innovation and strengthen systems of care. Through its work, CHCS identifies practical strategies for how states and their partners can leverage Medicaid innovation to strengthen access to care, improve care delivery, build workforce capacity, and promote long-term sustainability in rural and frontier areas.