At the 2025 Sanford Rural Health Summit panelists and healthcare professionals had conversations about the future of rural healthcare access across South Dakota and the country.
Federal Dollars to Address Major State Problems
One major topic of discussion was state access to new, one-time federal dollars meant to transform health care for rural areas.
While the exact funds available to each state aren’t known yet, the pot of money totals $50 billion.
“It’s safe to say, I think, that there’s going to be a sizable investment in rural healthcare in South Dakota," said Gov. Larry Rhoden, talking about federal dollars the state could get to improve healthcare access in underserved, rural areas.
The money is possible through the One Big Beautiful Bill Act, which created a $50 billion fund dispersed over the next five years called the Rural Health Transformation Program. It’s designed to improve access to hospitals, recruit and retain clinical workforce talent to rural areas and foster other positive health outcomes for rural areas.
Gov. Larry Rhoden’s office is at the front of the issue. As they gather information on what to do with the potential investment… “Well, I think a lot of just questions more than input on what it’s going to look like. And, of course, we’re on the front end of getting a lot of those questions answered ourselves," he said. "So, it’s going to be an evolving process as we get closer and things start coming into focus as far as even like how many dollars is it we can expect in South Dakota and how big of an investment that will be.”
He said they continue the search for comments, ideas and input on transformational projects in the state.
Some of the most underserved people in South Dakota are individuals on tribal reservations. According to the South Dakota Department of Health, as of July 2025 part of every Reservation was classified as a medically underserved area and experiencing a shortage of primary medical care.
Gov. Rhoden said he doesn’t specifically know if the tribes have given input on the issue. However, he said he expects they’ll have a bigger bite of the apple.
“Certainly, they will be impacted more than most people in South Dakota because of the rural," Rhoden said. "Nothing’s more rural than where the tribes are located especially in Western South Dakota.”
South Dakota, along with every other state, must submit applications for the funds to the Center for Medicare and Medicaid Services are due next month.
Technology Not Filling Urban-Rural Health Gaps...Yet
Another major topic of discussion at the summit was how technology and artificial intelligence, or AI, could expand healthcare access in rural areas. As technology advances, some think virtual care could step in and fill some of the gaps between rural and urban populations. That includes telehealth.
Some versions of telehealth have seen success in South Dakota, such as Telemedicine in Motion, which provides Emergency Medical Service Providers across the state virtual access to emergency medicine experts for better response calls.
Dr. Ateev Mehrotra is the chair of Brown University’s School of Public Health, as well as a panelist at the Sanford Rural Health Summit. He said telehealth could address the lack of care rural patients get compared to their urban counterparts...however... “In 2025, at least the data we have seen, nationally it’s done the opposite," Mehrotra said. "We see that urban patients are much more likely to use telehealth, and that gap between rural patients and their urban counterparts, has not shrunk, which is what I was hoping, but increased.”
He said that means something needs to change.
“It's not the technology; the technology can fix this problem. It’s rather how we're deploying it right now in the United States," Mehrotra said. "And so that’s really what I’m focused on which is how do we change the way that we’re using telehealth in the United States so that we can finally address that big gap.”
Other talking points of the panel was the role of AI in the hospital setting to better support issues rural providers come in contact with. One particular issue the experts hope AI can address is the shortage of nurses, doctors and other health professionals.
Emily Barey is a nurse and the Chief Nurse Evangelist at Epic, a healthcare software company. She said AI could definitely help in some places, but she doesn’t think filling the nurse shortage is a possibility.
“What we're finding of course is that when you’re using the AI, you’re really taking all the waste, all the low-value work out of the system, and of clicking for the sake of advancing a workflow is now a thing of the past, and we’re working on really truly making it a thing of the past," Barey said. "And what’s left is, again, that kind of last mile to the patient. And I think that’s where nurses in particular have a critical role.”
She said she thinks it’s nurses that are able to bridge the “last mile” where technology stops.
Dr. Mehrotra echoed similar sentiments, saying the tech can’t solve everything.
“I mean I think that we, and I would go back to the nursing example here, which is that there’s been so much emphasis on tech. It’s a great idea. It’s providing so much. But at the same time, we still need clinicians," Mehrotra said. "And I feel like we’re neglecting the concerns about do we have enough physicians? Do we have enough nurses? Do we have enough physical therapists? We have shortages, and yet our society is not really focused on how to address those shortages. And I don’t think technology is going to fix that problem, so we need to work on that in parallel.”
He likened the current climate around innovation’s rapid growth without time to have proper research behind it to the “Wild West.”
“In so many cases our history of medicine has been littered by great ideas that in for some reason in reality didn’t work out," Mehrotra said. "And so, I am worried both by the fact that we are introducing so much without the evidence, it’s going to harm patients in that in our pilot testing or trying things out.”
He said he admires the innovation and creativity to use tools, but the healthcare ecosystem right now doesn’t reward evidence.
Dr. Nworah Ayogu is a partner at Thrive Capital who was also on the panel. He said with the innovation and technology available; this is a chance to change healthcare access for everyone.
"We have an analogy we use a lot of like binoculars vs telescopes. You can use both of them to see far, but if you talk to actual astronomers about telescopes, they’ll tell you, ‘No. The point of a telescope isn’t to extend your vision. The point of a telescope is that you can see spectrums of light you can’t see otherwise,’" Ayogu said. "And I think of AI the same way that the point of this is not to, ‘Okay well doctors and nurses do these tasks. So therefore, we’re going to do these tasks efficiently.’ And yes, we should do that. But if that’s all we’ve done in 10 years we’ve failed. What a doctor does in 10 years, what a nurse does in 10 years, should be fundamentally different from what they do today.”
He said that could have a ripple effect beyond just South Dakota or even the US.
“But to me it’s more important if we think about what America is. We are, we’re the City on the Hill. Right? We’re the light on the hill. We’re supposed to be a model to the rest for the world," Ayogu said. "When you think about the world, 3 billion people in the world live in rural settings. So, it’s actually an even bigger problem worldwide. And to me I think a lot about if we can solve it here, are those things that we can export to the rest of the world, the 3 billion people who live in rural Earth?”
He said figuring issues out locally and remotely could benefit everyone.
