North Dakota's health system: a model for the nation's health care? North Dakota faces health care challenges common to many rural areas of the United States, but the state’s health care system has features that other rural and urban regions of the nation can learn from. A new Commonwealth Fund report shows how North Dakota is getting it done. The report, The North Dakota Experience: Achieving High-Performance Health Care Through Rural Innovation and Cooperation, discusses innovations in the state that enhance health care access and quality, and hold down health care costs. Describing lessons obtained from a visit to the state by members of The Commonwealth Fund’s Commission on a High Performance Health System, the report describes North Dakota’s collaborative efforts to support primary care and medical homes, cooperative networks of providers that help organize care delivery, and innovative use of technology to meet patient needs and hold down costs. The lessons are particularly relevant to rural America but also have implications for how health care can be delivered in urban parts of the United States. “Health care providers, payers, and policymakers in rural North Dakota have learned that only through cooperative, interdependent relationships and a willingness to innovate in both the organization and regulation of services can they achieve the reach, care coordination, and economies of scale that are necessary for delivery of quality and efficient care in rural settings,” the report notes. From difficulties attracting health care professionals to deploying adequate resources in small, geographically dispersed communities, North Dakotans have come up with creative, cooperative ways to provide residents with accessible, good-quality, efficient health care services. “Policymakers considering the future for United States health care may take a cue from well-functioning rural health care systems such as those described in North Dakota,” the report notes. “The nation may have to learn more than just technique from rural areas. It may need to relearn what it means to be a community of neighbors.” “When you’re talking about health care, people sometimes assume that ‘bigger is better’. This report finds just the opposite. Highlighted are excellent rural examples of how health care can be improved, based on cutting edge innovation in payment policy, technology applications, and a spirit of cooperation rather than competition. Features of high performance in health care can be found in rural America, just as they can be found in urban America,” said Mary Wakefield, associate dean for rural health and director of the Center for Rural Health at the School of Medicine and Health Sciences. Dr. Wakefield also serves on the Commonwealth Fund’s Commission on a High Performance Health System. To view the full report, visit: http://ruralhealth.und.edu/pdf/Commonwealth_North_Dakota_Experience.pdf -- Wendy Opsahl, Communications Coordinator, Center for Rural Health, wopsahl@medicine.nodak.edu, 777-0871