South Dakota Earns No. 1 Ranking in 2026 MBQIP Awards
For the third consecutive year, South Dakota has been recognized by the National Rural Health Resource Center among the nation’s top-performing states in the Medicare Beneficiary Quality Improvement Project (MBQIP) Awards. This year, the state reached the top of the list by ranking 1st among the 45 states participating. The award was presented at the Flex Program Reverse Site Visit in July in Washington, DC.
The recognition is a tremendous accomplishment for rural health care in South Dakota, but it is also an achievement that belongs to the state’s Critical Access Hospitals (CAHs) and the dedicated teams working in them every day.
The MBQIP Awards evaluate both quality reporting and quality performance, making South Dakota’s No. 1 ranking especially significant. The 2026 analysis used quality measure data reported by participating CAHs from January through December 2024. The evaluation incorporated measures related to emergency department transfer communication, emergency department care, CAH quality infrastructure, patient safety and patient experience, and combined reporting rates and performance scores to determine the overall ranking.
MBQIP, launched in 2011, was created specifically to improve the quality of care provided in Critical Access Hospitals by increasing quality data reporting and using that information to drive quality improvement. Nationally, the program works with rural CAHs across the 45 states participating in the Flex Program, encouraging hospitals to collaborate on quality improvement initiatives and share strategies that can improve outcomes.
For South Dakota to rise to No. 1 nationally, its hospitals had to do more than simply submit paperwork.
They had to perform.
They had to measure.
They had to report.
And, most importantly, they had to continually look for ways to improve.
A Three-Year Record of Excellence
South Dakota’s 2026 recognition builds on a remarkable three-year run of MBQIP success.
The state was recognized in the 2024 MBQIP Awards, followed by another top-tier recognition in 2025, when South Dakota tied for sixth nationally. In 2026, South Dakota moved all the way to No. 1.
The 2026 rankings place South Dakota at the top of a competitive field of 45 participating states. The rankings are as follows:
- South Dakota
- New Hampshire
- Iowa
- Pennsylvania and Virginia
- Hawaii
- Nebraska
- West Virginia
- Oklahoma
- Minnesota
- Kansas
This progression reflects sustained work inside South Dakota’s rural hospitals. Quality improvement is not a one-time initiative; it requires continued attention to data, reporting, clinical processes, patient experience and outcomes year after year.
The Award Starts with South Dakota’s CAHs
While the award recognizes South Dakota as a state, the accomplishment begins at the individual hospital level.
Every Critical Access Hospital in South Dakota participates in MBQIP and this data contributes to the state’s overall performance. Behind those data submissions are nurses, quality professionals, clinicians, hospital leaders, medical records staff, infection preventionists, emergency department teams and countless other employees who make sure the right actions are taken, and the right information is collected, reviewed and submitted.
That work can be particularly challenging in rural hospitals, where staff members frequently manage multiple responsibilities and resources are often limited. Yet South Dakota’s CAHs continue to make quality a priority, with their efforts producing results.
The South Dakota Association of Healthcare Organizations (SDAHO) and the South Dakota Office of Rural Health support CAHs through MBQIP resources, education and quality improvement assistance. The program gives hospitals opportunities to examine their own data, compare results with other CAHs and partner with other hospitals around quality improvement.
After three consecutive years of national recognition, South Dakota’s CAHs have given the state—and the communities they serve—another reason to be proud.
Michelle Jury, RN Clinical Improvement Consultant with SDAHO, has been working with South Dakota’s Critical Access Hospitals on MBQIP since 2021. As part of her broader work supporting Critical Access Hospitals, Michelle provides MBQIP assistance through the Flex Program in partnership with the South Dakota Office of Rural Health and Emergency Services. “Our hospitals in South Dakota should take great pride in this accomplishment. It is wonderful to see this recognition on a national level, and they are so very deserving. Every day, staff at these rural facilities work hard, wearing many different hats and it can be difficult to begin new projects and advocate for change and improvement when it all takes time and there never seems to be enough of that. But South Dakota has wonderful rural facilities and staff that want to provide the best care they can for their friends and neighbors, and it shows in this award.”
To learn more about the MBQIP Program, visit this link on the SDAHO website or reach out to Michelle Jury at michelle.jury@sdaho.org
Resources: National Rural Health Resource Center, Flex Monitoring Team
