This bill, known as the "Rural Hospital Flexibility Act of 2025," seeks to significantly strengthen and expand the Medicare rural hospital flexibility program grants. It broadens the scope of activities that can be supported for critical access hospitals, certified rural health clinics, and rural emergency hospitals, encompassing quality improvement, population health initiatives, and services addressing behavioral health and substance use disorders. Additionally, the Secretary is authorized to award grants for technical assistance, data analysis, and evaluation to entities already receiving grants under other provisions, helping them carry out their activities more effectively. A key change involves redirecting certain grants from individual hospitals to State Offices of Rural Health , which can then use these funds for purchasing computer software and hardware, and for staff education on billing, operational improvements, and quality-focused efforts. The bill also establishes new Rural Health Transformation Grants , offering 5-year awards to State Offices of Rural Health and eligible rural health care providers to facilitate transitions to new models such as rural emergency hospitals, extended stay clinics, and integrated behavioral and oral health services. Furthermore, it creates grants for Rural Emergency Hospital Technical Assistance , providing support and data analysis to hospitals seeking or already designated as rural emergency hospitals.