We invite rural patients and residents; hospitals, clinics and provider networks; community-based organizations, tribal partners and other stakeholders to participate in our survey and share your input. Your feedback is critical to shaping the plan to best serve North Dakota’s rural communities.
Opens Aug. 13, 2025 | Deadline to respond is Sept. 12, 2025
Rural Health Transformation Program Survey Questions
Overview
The One Big Beautiful Bill Act (Section 71401) creates a new Rural Health Transformation grants program administered by the Centers for Medicare and Medicaid Services (CMS), allocating $50 billion nationwide from federal fiscal years 2026 through 2030 — $10 billion annually. Funds will flow through states, which must submit a Rural Health Transformation Plan to CMS by Dec. 31, 2025, to access and manage these resources.
North Dakota is expected to receive approximately $100 million per year, totaling $500 million over five years, to improve rural health care access, quality, and sustainability.
What is the Rural Health Transformation Plan?
States must submit a one-time application to CMS, including a plan that outlines how the state will:
Improve access to hospitals, providers, and health care services for rural residents
Enhance health outcomes for rural communities
Use emerging technologies focused on prevention and chronic disease management
Strengthen partnerships between rural hospitals and providers to improve quality and financial stability
Support recruitment and training of rural health care clinicians
Prioritize data-driven solutions and technology to deliver high-quality care close to home
Address financial solvency and operating models of rural hospitals
Identify causes driving hospital closures, conversions, or service reductions
Eligible Activities
States must fund at least three or more designated activities.
Evidence-based prevention and chronic disease management interventions
Payments to providers for specified services
Consumer-facing technology solutions for chronic disease management
Training on advanced tech such as remote monitoring, AI, and robotics
Recruiting and retaining rural clinical workforce with service commitments
IT upgrades improving efficiency, cybersecurity, and outcomes
Helping communities optimize health care delivery systems
Expanding opioid use disorder, substance use, and mental health services
Innovative care models including value-based care and alternative payments
Other CMS-approved activities to ensure sustainable rural health care
North Dakota’s Outreach and Engagement
As we await CMS guidance, HHS is actively engaging with stakeholders to gather feedback on shaping the state's Rural Health Transformation Plan. HHS expects to receive guidance from CMS in Fall 2025.
Take the Survey
We invite rural patients and residents; hospitals, clinics and provider networks; community-based organizations, tribal partners and other stakeholders to participate in our survey and share your input. Your feedback is critical to shaping the plan to best serve North Dakota’s rural communities. The survey takes 15-20 minutes to complete. The information gathered will be used for planning and information-gathering purposes only. Deadline to respond is Sept. 12, 2025.
Opens August 2025