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Listening Sessions

North Dakota Health and Human Services is hosting virtual listening sessions on the state’s Rural Health Transformation Program. During these sessions, agency leaders will share key themes from the recent Rural Health Transformation Program survey and gather feedback from participants about priorities for North Dakota's Rural Health Transformation Program application.

Register for one of three listening sessions by getting a ticket. After registering, you will receive an email confirmation with a meeting link and call-in information. 

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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.

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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

HHS is engaging with stakeholders to help shape North Dakota’s Rural Health Transformation Program. A month-long public survey was launched on Aug. 13, followed by three listening sessions scheduled in October to share survey results and gather more input. The state’s application must be submitted by Nov. 5, 2025, to the Centers for Medicare and Medicaid Services (CMS) with awards announced by Dec. 31, 2025. States will partner with CMS to ensure strong oversight and lasting impact. 

Federal Resources 

Rural Health Transformation Program - Centers for Medicare and Medicaid Services
Rural Health Transformation Program grant opportunity - Grants.gov   

Page updated:  Sept. 17, 2025