CONCORD, N.H. — New Hampshire will receive $204,312,551 in the second year of the federal Rural Health Transformation Program, Gov. Kelly Ayotte's office said, the largest award in New England.

The money from the Centers for Medicare & Medicaid Services is more than the state received in the program's first year and brings New Hampshire's total to more than $408 million over two years, according to the governor's office.

"New Hampshire has once again secured the largest Rural Health Transformation award in New England, with an increase in funding from last year," Ayotte said in a statement. She credited GO-NORTH, the state office running the program, and the Department of Health and Human Services for putting first-year money to work quickly.

Unlike the first round, second-year awards were based partly on how far each state had come in carrying out its CMS-approved rural health plan, the governor's office said. All 50 states filed annual progress reports, which CMS reviewed in setting the new funding levels.

CMS Administrator Dr. Mehmet Oz said the $50 billion national program gives states "the resources and flexibility to bring care closer to home." He said the new round would help New Hampshire build on its first-year progress.

GO-NORTH Director Donnalee Lozeau said the state has put more than $11 million into rural emergency medical services and Mobile Integrated Health. The office has also opened funding opportunities in rural primary care, school-based oral health, rural hospitals, health care workforce education for young people and adults, rural home health, children's behavioral health and community mental health, she said.

That work has been done with five partner organizations, Lozeau said: the Foundation for Healthy Communities, the Community College System of New Hampshire, the University System of New Hampshire, the Community Development Finance Authority and the New Hampshire Community Behavioral Health Association. She said the second-year money will allow the office to issue more awards over the next year.

According to the governor's office, GO-NORTH and DHHS have also focused on keeping the investments going long term, including expanding services for children with complex behavioral health needs, adding integrated behavioral health at the state's community mental health centers, and trying new care and payment models in Medicaid to protect hospital and primary care access in rural areas.

DHHS Commissioner Lori Weaver said the second-year funding will go toward strengthening the health care workforce, expanding access to primary and behavioral health care and making new technology more available in rural communities.