North Dakota

Guest Column: Celebrating innovation and opportunity in North Dakota on National Rural Health Day

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It is no secret that there are many challenges confronting rural health care right now, from workforce shortages and declining reimbursement rates to threats to programs like 340B that support safety-net hospitals. But this week, as we celebrate National Rural Health Day on Nov. 20, I am reminded of the many reasons to be hopeful about the future of rural health care.

Earlier this month, the state of North Dakota applied for a share of the $50 billion that will be distributed nationwide beginning next year as part of the newly established Rural Health Transformation Program. With $1 billion on the line for North Dakota, the program could be one of the single greatest investments in rural health that our state has ever seen.

The Rural Health Transformation Program was designed to spur innovative and sustainable approaches to better serve the farmers, ranchers and small business owners who call rural communities home. And in order to qualify for funding, North Dakota crafted an application that demonstrates a strong vision for improving the health of our neighbors and stabilizing rural health care delivery.

As a health system that’s proud to serve mostly rural areas, Essentia Health was grateful to share our ideas for how hospitals can stabilize essential services, such as behavioral health and emergency care, while advancing workforce development and value-based care for the rural and Tribal communities we are privileged to serve. As we wait for the funding to be awarded, I am confident that North Dakota’s application is strong because it reflects the real experience and perspectives of compassionate caregivers on the front lines of rural care.

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Here’s why I’m excited by this opportunity:

Attracting and retaining a strong health care workforce remains one of the most significant challenges confronting rural care. North Dakota’s application dedicates over $162 million to train and retain a high-skilled workforce through new residencies, workforce pipelines and recruitment and retention grants.

At Essentia, we’ve had success with first-of-its-kind training programs that address critical gaps in our health care workforce. We just celebrated the first graduate of our surgical technologist apprenticeship program in Fargo. These are the kinds of innovations we must continue pursuing to help care teams like ours advance our mission to make a healthy difference in people’s lives.

If awarded this funding, North Dakota plans to deepen its work to bring high-quality health care closer to home – a mission that Essentia Health whole-heartedly stands behind. With fewer clinicians to staff brick-and-mortar facilities, we need to get creative to meet people where they are – through new methods and in new spaces. A person’s access to expert care shouldn’t be determined by their zip code.

Essentia’s mobile mammography program is one example of how we can enhance access to preventive care without relying on traditional settings. The program brings essential mammography services directly to our neighbors in rural areas and could be expanded across other specialties. Since we rolled out this service, we hear repeatedly from patients who acknowledge they likely wouldn’t have done a screening if it hadn’t been available locally. Rural Health Transformation funds could be used to deploy mobile medical units to rural, underserved communities, with specific services tailored to the greatest needs of the community.

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Finally, this funding would allow us to expand scalable programs, like our community health workers and community paramedics. These programs provide tailored support to patients with the goal of diminishing the rate of chronic disease, improving the health of our rural neighbors and reducing emergency room visits and hospital admissions.

The work to transform the future of rural health care has already begun at Essentia Health. The Rural Health Transformation Program represents an opportunity to expand our efforts to bolster our health care workforce, strengthen a care model that prioritizes prevention and patient outcomes and make it easier for North Dakotans to access comprehensive health care close to home.

As we celebrate National Rural Health Day, I am hopeful for the future of rural health care and especially grateful for my talented colleagues, whose dedication to advancing rural health care strengthens the communities where they live and work.

Dr. Stefanie Gefroh is the Essentia Health West Market president.





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