Historically, many rural hospitals and organizations were early adopters of telehealth due to the challenges rural residents faced in accessing care.  Barriers included things like geographic distance, lack of a public transportation infrastructure, along with issues with provider shortages and their distribution/concentration in urban centers.  Rural healthcare facilities were frequently the recipients of rural health grants and formed the foundation for historical "hub and spoke" model of telehealth.  The availability of telehealth services frequently allowed patients to remain in their community for care.

While telehealth best practices and policies are typically not different for rural hospitals and clinics than for other facilities, rural facilities face some unique challenges. These include financial viability due to low patient volumes, older populations who require more services and who frequently rely on government payers,  aging infrastructures and more.  Therefore, several resources related to telehealth specific to rural health have been developed.  These are featured here:

Telehealth Resources for Rural Hospitals and Healthcare Organizations

  • Strengthening Telehealth Skills for the Rural Healthcare Workforce:  This resource compiles hyperlinked training materials, tools, and technical assistance resources to help rural healthcare organizations build telehealth workforce capacity. Organized into eight key areas, it covers telehealth fundamentals, workforce development, clinical best practices, patient engagement, technology and innovation, emergency preparedness, reimbursement and sustainability, and regional support. The resource is designed to help rural providers strengthen telehealth skills, expand access to care, and deliver high-quality virtual services.
  • Practical Guide to Support Innovation in Rural Health (June 2026): This resource highlights promising practices that support innovation in rural health systems and community-based organizations. This guide is designed to help rural health programs, practitioners, and partners understand innovation in a rural context, identify practical strategies that meet local needs, and move from ideas to implementation. This guide includes strategies, tools, and examples that rural communities can use to design, implement, and scale innovative approaches that build on local realities and strengths.
  • Transforming Rural Hospitals through Telehealth Partnerships: Strategic Playbook (January 2026).  The MUSC Telehealth Center of Excellence's playbook outlines strategies for rural hospitals to enhance financial sustainability and clinical capacity through telehealth partnerships. It introduces a maturity model with three levels—early, operational, and transformational—across key domains like strategic approach, workflows, staffing, and financial commitment. The playbook emphasizes tailored telehealth integration to improve care delivery and community health outcomes.
  • Critical Access Hospital Telehealth Guide (February 2024): This Guide provides practical guidelines on implementing and sustaining telehealth to optimize health care delivery, expand access, enhance care coordination, and address health inequity.  The guide primarily focuses on Medicare outpatient telehealth services but includes Medicaid coverage and remote services that may not strictly be considered telehealth.
  • Telehealth Implementation: A Guide & Case Study for Critical Access Hospitals:  This webinar provides practical guidance on implementing and sustaining telehealth to optimize health care service delivery, expand access, and enhance care coordination for Critical Access Hospitals (CAH). Just as health care organizations strive to take a person-centered approach to health care, this guide seeks to take a CAH-centered approach to telehealth that keeps the patient and community at the forefront.

  • Telemedicine Applications for Small & Rural Hospitals: Guide developed by the American Society of Hospital Pharmacists (ASHP) to share ideas on ways telemedicine and telehealth have been used in small and/or rural hospitals to serve the needs of patients and communities.

Medicare has made several policy changes related to telehealth.

Rural Health Transformation (RHT) Program. On November 5, 2025, the Centers for Medicare and Medicaid Services (CMS) announced that all 50 states have submitted applications for the RHT Program. Created by Congress to address concerns stemming from the deep funding cuts in H.R.1, the RHTP will distribute $10 billion annually from 2026 through 2030; 50% of those payments will be distributed equally across states with an approved Rural Health Transformation Plan, while the remaining half will be distributed to states at the discretion of CMS, according to factors detailed in the funding announcement

Ingenium Digital Health Advisor's Rural Collections: