The Northern Marianas secretary of health says it is not just increased funding that is needed to improve hospitals in the United States territories.
A study, published in the Journal of Internal Medicine, found patients treated at hospitals in the territories have higher death rates and worse health outcomes than those in the US states.
Joseph Kevin Villagomez says the rise of non-communicable diseases, like diabetes, has increased the mortality rate - and significantly more so than on the mainland.
"Funding is one, it's not the only thing, because recently there's been a lot of funding especially with the Affordable Care Act. It puts more emphasis on, or puts a lot of funding into prevention. And granted that we're probably going to still see a generation of our people coming through with a higher non-communicable disease rate. The goal is to get this prevention programme in place now."
Joseph Kevin Villagomez, the CNMI secretary of health.
