ND submits Rural Health Transformation application aimed at strengthening care in rural communities

BISMARCK, N.D. - Gov. Kelly Armstrong today announced that North Dakota submitted its Rural Health Transformation Program application to the federal Centers for Medicare & Medicaid Services (CMS). The application outlines how the state will invest more than $500 million over five years to strengthen rural health care by improving access, quality and outcomes for North Dakotans in rural communities.

"North Dakota is a proud rural state. Whether you live in Beach or Belcourt, Crosby or Colfax, or anywhere in between, North Dakotans should have access to high-quality health care," Armstrong said. "The Rural Health Transformation Program gives us an opportunity to think about ways to bring sustainable and transformational care to our rural communities. We appreciate President Trump, CMS Administrator Oz and our congressional delegation for supporting this funding that will be transformational for health care delivery in North Dakota."

Signed into law as part of the federal One Big Beautiful Bill Act, the Rural Health Transformation Program empowers North Dakota to reimagine how rural health care is delivered and create innovative, lasting solutions that meet the needs of local communities.

The state's application centers on four strategic initiatives: strengthening and stabilizing rural health workforce; making North Dakota healthy again with preventive care and healthy eating; bringing high-quality health care closer to home; and connecting technology, data and providers for a stronger North Dakota.

"This is a once-in-a-lifetime opportunity to strengthen rural health care delivery in North Dakota," said Pat Traynor, interim commissioner of North Dakota Health and Human Services (HHS). "Our plan prioritizes better access to care and long-term wellness while advancing our vision to make North Dakota the healthiest state in the nation."

Each initiative includes proposed activities supported by the funding, such as creating new workforce pipelines for rural health through expanded residencies and training programs and launching North Dakota Moves Together to encourage physical activity and community connection. Other initiatives include developing telehealth infrastructure for local primary, behavioral health and specialty care, and building a modern, connected statewide health care data hub.

Sarah Aker, HHS medical services executive director, said the state's application was shaped predominantly from stakeholder feedback and support from North Dakota lawmakers.

"Our goal from the beginning was to listen first," said Aker. "The ideas and priorities came directly from the people who know rural health care best - our residents, providers, tribal partners, community leaders and other partners across the state."

To gather input, HHS launched a 30-day survey that received more than 1,200 responses and hosted three listening sessions attended by over 300 participants.

The federal law appropriates $50 billion over five years, splitting half equally among all states. The other half will be given to states based on their applications and metrics that show where the funding can make the biggest health impact in rural communities.

CMS is expected to announce award decisions by Dec. 31, 2025.

To learn more about the Rural Health Transformation Program and to review the state's application, visit hhs.nd.gov/rural-health-transformation.