Care Without Distance: Rural Health's Leap Into The Digital Age

Forbes

2 days ago

The rising cost of delivering care to rural Americans is only one part of the story. What matters most to patients, and to those of us who have spent our careers caring for them, is getting care when and where it's needed, in the most convenient (and yes, affordable) way possible.
When I was practicing surgery as a heart specialist, many of my patients came from small towns. They were referred from rural clinics that were doing their best, often without resources or specialist support. I saw firsthand how delays in diagnosis or distance from care could change the course of an illness. These experiences stay with me. They are part of why I believe so strongly that we can and must build a better, more connected system for rural America.
This moment in time, I believe, brings both hope and genuine opportunity. With the right strategy and newly available technologies, we can deliver care that is closer to home, more consistent, and more personal. Daily advances in artificial intelligence (AI), digital health, and virtual care are opening the doors to revolutionary new ways to connect patients to care. These methods are already transforming delivery in other parts of the country and the world.
In July 2025, Congress passed the One Big Beautiful Bill Act which includes the Rural Health Transformation Program, an innovative $50 billion federal initiative to support rural communities to be disproportionately impacted by the Act's Medicaid spending cuts and other reimbursement reductions.
Beginning in 2026, the Centers for Medicare & Medicaid Services (CMS) will allocate $10 billion annually through 2030 to states that submit qualifying transformation plans. These funds will support high-priority initiatives such as broadband expansion, digital infrastructure, chronic disease management, and training for the adoption of technologies such as AI and remote patient monitoring.
Though limited in size and scope, the Transformation Program represents a meaningful down payment on a more modern and equitable rural health sector. It's more than a funding package; it reflects a growing recognition in Washington that transformative technology, especially AI, must play a central role in the future of rural health.
In Part Two of this series, we documented the impact of rural hospital closures. But we don't need to rebuild what was lost brick by brick. We can build something better: care that moves to and with the patient, not just inside a building. And rural communities, with their strong culture of self-reliance, adaptability, resilience, and strong local ties, are uniquely positioned to benefit from and potentially lead this transformation.
Barriers to Access—and Why They Must Be Overcome
Rural America is home to 60 million people, nearly one in five Americans. Yet these communities experience some of the worst health outcomes in the country. Chronic illnesses are more common. Life expectancy is shorter. And getting timely, high-quality care is harder than ever.
On average, rural Americans live twice as far from the nearest hospital as their urban or suburban peers. That distance is growing as more rural hospitals and clinics close, many operating on razor-thin margins with aging infrastructure and too few clinicians to sustain services. As discussed in Part One, these facilities are more than care sites. They are employers, civic institutions, and sources of community trust. When one closes, the effects ripple out. A single hospital closure can lead to a 14% decline in employment in the county it served.
Fewer young doctors are choosing to practice in rural communities. Medical specialists are nearly nine times more concentrated in urban areas than rural ones. The provider shortage is worsening just as demand for care, especially for chronic conditions and behavioral health, is growing.
To break this cycle, we need to reimagine how care is delivered. That means shifting away from the narrow model of centralized, inpatient facility care and toward more connected outpatient and community-based systems, including mobile care, telehealth, and in-home services. But to get there, we must invest in the infrastructure that will make this possible.
That's where modern technology, and AI in particular, can play a transformational role.
Laying the Groundwork for a Digital Rural Health System
Before rural communities can fully benefit from artificial intelligence and other cutting-edge technologies, they need the right foundation. And today, that foundation is uneven at best.
Many rural hospitals and clinics rely on outdated electronic medical records that can't share data or integrate with newer tools. Only about 64% of rural physicians use certified electronic health record systems. Twenty-two percent of rural households lack access to high-speed broadband. Most small, independent hospitals can't afford to have dedicated IT or cybersecurity staff. And while AI is becoming a more common feature in many industries, fewer than 1% of rural Americans feel confident using it in the workplace, though the majority say they want to learn.
These gaps matter. Because if we don't address them now, rural America risks falling even further behind as digital care models increasingly become the norm.
What's needed is clear:
Some organizations are already taking action. Thrive Health Tech*, a company we helped incubate at Frist Cressey Ventures, equips patients with mobile devices that connect to a HIPAA-compliant wireless network, helping bridge the broadband gap in hard-to-reach communities. Major technology companies are beginning to partner with rural hospitals to modernize their cybersecurity systems and digital infrastructure.
But scaling these solutions takes more than innovation alone. It will require new commitments to public-private partnerships with policy alignment and sustained investment.
That's what makes the Rural Health Transformation Program so interesting. With $10 billion in federal funding each year between 2026 and 2030, the program gives states the opportunity and the incentive to build the appropriate infrastructure that rural health requires to thrive in the digital age.
From Potential to Practice: How AI Is Already Advancing Rural Health
Advancements in multi-modal language models, reasoning models, and voice agents are central to this innovation. Investments in frontier models and technical ingenuity of engineers are producing tools that are changing care delivery for the better. These are the building blocks for the hospitals and clinics of the future.
Once the foundation is laid, rural communities are positioned to move from planning to action. Across the country AI tools are already being deployed to support patients, reduce administrative burdens, and enhance how clinicians deliver care. These tools are not theoretical. We know they work, and they are especially well-suited to the needs of rural populations, where distance and access are larger barriers to health.
At Frist Cressey Ventures, we sit at the front line of technology innovation in healthcare. Through deep relationships with founders, health systems, medical groups, and independent physicians, we see the impact that AI applications are having on patient outcomes, clinician satisfaction, and operational efficiency at sites of care. For illustration purposes, here are some of what we are seeing in rural health today:
AI-enabled platforms are enhancing how patients understand and manage their own health. Large language models can deliver personalized education, explain care plans in everyday language, and do so in multiple languages and literacy levels by text or voice.
When paired with remote monitoring, this creates a continuous, real-time link between patients and their care teams. In places where behavioral health access is limited, AI-powered applications have been shown to be highly effective in providing structured talk therapy and supporting people burdened with social isolation, depression, or chronic illness.
One compelling example of reaching rural communities is Sprinter Health, which deploys trained clinical staff to patients' homes in rural areas like Kentucky, Maine, and Louisiana. Using a custom logistics platform powered by AI, Sprinter aligns clinician travel with outreach needs, creating efficient, high-density routes, even in the most remote zip codes. These visits, often funded by health plans and paired with remote nurse practitioner consults, reconnect patients with care on their own schedules, reducing barriers and improving outcomes.
Clinicians in rural America are asked to do more with less. AI tools help them reclaim time for what matters most: patient care. Voice-enabled documentation, automated coding, and streamlined prior authorizations reduce the suffocating administrative burden while improving billing accuracy and compliance. These tools also reduce physician and nursing burnout.
One example: Ambience Healthcare* provides a suite of AI tools, including AI-enabled 'ambient scribes' with an integrated coding and compliance engine that have led to a 40% decrease in documentation time. Some health systems have reported revenue increases of $13,000 per physician annually by using these tools.
AI is also helping rural clinics and hospitals improve their back office, automating scheduling, eligibility checks, and insurance workflows. Language models are flagging coding errors, demystifying payer rules, and reducing costly denials. These improvements aren't flashy, but they're critical to keeping rural providers financially solvent. An example is CodaMetrix*, which has shown a 70% reduction in manual coding work and a 60% drop in coding-related denials using digital automation and AI tools.
AI is also bridging the specialist gap. Advanced clinical reasoning models are being used to supplement rural clinicians' decision-making, offering diagnostic recommendations when specialists aren't available. In radiology, large vision models can review and triage imaging studies, highlighting urgent cases for rapid interpretation.
In Kenya, OpenAI's partnership with primary care provider Penda Health, though in a different setting, has shown what's possible: a 16% reduction in diagnostic errors over 40,000 patient visits.
This kind of augmentation won't replace local physicians. It will support and extend their reach, ensuring that rural patients, who by geography are typically more physically distant from their providers, receive the same standard of care as those in more urban centers.
Governance and Guardrails: Making AI Safe, Trusted, and Transparent
While the promise of AI in rural health is real, we must proceed thoughtfully. The speed of innovation cannot come at the expense of safety, patient trust, or clinical integrity. And in rural settings, where resources are stretched and IT support may be more limited, clear guardrails are essential.
AI tools must be explainable. They must be tested for bias. They must work consistently across diverse populations and care settings. And they must be monitored in real time so that rural hospitals and clinics know exactly how these systems are performing. Importantly, technology exists today to make this possible, even for rural independent facilities outside larger, more resource-complete systems. Companies like Qualified Health* are building platforms that allow rural providers to implement AI safely and smartly. Their systems provide audit trails, performance dashboards, and governance frameworks that give local teams control as well as convenience and safety.
Technology alone won't change rural health. But technology implemented wisely with strong community buy-in and a commitment to safety can. And rural communities, free of many oftentimes restraining legacy systems, may well be the best situated to lead.
We've seen it before in other fields. In parts of Africa and India, mobile phones bypassed traditional landline infrastructure altogether. In China, electric vehicle adoption accelerated because the country leapt directly into the next generation of mobility.
Rural America has the same potential when it comes to health. Indeed, rural providers can leapfrog older models and become national leaders in delivering smarter, more equitable care.
A Future Within Reach
Rural health is not failing. It is changing.
Yes, many inpatient hospitals are struggling, and recent Congressional action in reimbursement and Medicaid cuts make the environment more challenging. Many have closed, and many feel that the recent reconciliation law will lead to the demise of others. But this does not have to be an end of care in rural America. In fact, it opens the door to something better, built for today and for tomorrow. A system more responsive, more connected, and more sustainable than what came before.
The Rural Health Transformation Program is not a silver bullet. It is limited in size, and it cannot address every challenge rural providers face. But it does point in the right direction. It signals that rural health care matters, and that technology, wisely applied, can help power a system that works better and more sustainably for patients, caregivers, and communities.
This isn't just about modernizing infrastructure. It's about honoring the values that make rural America such a powerful place to lead this change. In rural communities, people take pride in self-reliance and resourcefulness. They know how to figure things out. They trust neighbors more than distant systems. They solve problems without waiting for someone else to do it. And they've long practiced the kind of resilience that will be needed to adapt, lead, and thrive in a new model of care.
That new model won't rely on size. It will rely on connection. It will deliver care not just in hospitals, but in homes, local clinics, and mobile units. With the right technology in place, rural providers can leapfrog outdated systems and become national leaders in delivering smarter, earlier, and more personal care.
Rural America has always led in farming, in military service, in faith and family. It can lead in health care, too. That's what this moment offers. Not a return to the past, but a chance to shape the future. A future defined by innovation, partnerships, connection, and care.Frist Cressey Ventures, of which the author is a partner, has a minority investment in the companies marked with an asterisk above. They are for illustrative purposes only.