16 Proven Telehealth Solutions
Improving Access to Rural Primary Care

Primary care is the foundation of a high-functioning healthcare system, but in rural America, it is also one of the most fragile. Many communities lack enough clinicians so patients often have to travel long distances even for basic services, and chronic disease rates continue to rise without consistent follow-up. These challenges lead to avoidable emergency visits, delayed diagnoses, and worsening health outcomes.

The CMS Rural Health Transformation Program (RHTP) has set aside $50 billion to help rural providers redesign sustainable care delivery. As part of our Telehealth Tuesday series on proven telehealth solutions for improving access to rural care, we’ve already examined opportunities in hospital care and emergency care. This third article focuses on primary care — highlighting 16 solutions that rural leaders can use to expand access, integrate services, and sustain their workforce.

Telehealth in Primary Care

Even though it’s the most used outpatient service, primary care is a relative late-comer to video visits. Early adopters were specialty care services of academic medical centers, followed by behavioral health services gaining “online” popularity with virtual-only visits (more on behavioral health in the next article).

Telehealth-enabled primary care services can be grouped into three categories:

Expanding access: making it easier for rural patients to connect with a provider when and where they need care. By far the most commonly used version of video visits.

Supporting the workforce: extending the capacity of rural clinicians and creating new pathways to recruit and retain staff. While even more prevalent in clinical subspecialties or behavioral health, allowing more “work from anywhere” flexibility can also expand to primary care.

Integrating care: embedding behavioral health, pharmacy, and care management into primary care to improve outcomes and reduce fragmentation. Primary care never acts “alone”. A good primary care provider is the quarterback of the patient’s care journey, directing and summoning other specialties.

Together, the telehealth use cases under these three umbrellas provide a roadmap for rural healthcare organizations to build resilient, scalable primary care delivery systems to fulfill the objectives of the Rural Health Transformation Program.

Expanding Access to Rural Primary Care

Primary care access in rural areas is often limited by geography, transportation, and the availability of clinicians. Telehealth offers flexible, community-centered ways to lower these barriers and ensure patients get timely care.

Here are a number of common scenarios that do expand access:

1. Direct-to-Patient’s Home: The most common scenario during Covid. Patients can connect with their primary care provider through secure video or phone visits from their own home, reducing travel barriers. This increases convenience, strengthens continuity of care, and builds patient trust in local providers: I can get to you when I need you (and I don’t need to go anywhere else).

2. Telehealth at Places of Employment: Employers can establish private telehealth rooms or install telehealth kiosks as a workforce benefit, which is particularly valuable in rural areas where time off for appointments often amounts to at least half a day. This reduces absenteeism, supports preventive care, and reinforces the local partnership between employers and healthcare organizations, something that the RHT program encourages.

3. School-Based Telehealth: Rural schools can serve as access points for pediatric visits, acute care, and behavioral health consults delivered via telehealth. These programs not only minimize missed class time for students but also give teachers and school staff convenient access to primary and behavioral care during the school day — supporting both community health and workforce stability while maximizing learning time.

4. Virtual First-Contact and Same-Day Telehealth Visits: Patients can schedule same-day telehealth appointments or connect with a triage nurse virtually, reducing delays and unnecessary emergency visits. This improves continuity of care, builds trust in local care providers, and keeps care within the rural system.

5. Community-Based Telehealth Access Points: When patients don’t have the technology, the connectivity, or the digital literacy, schools, libraries, and community centers can host secure telehealth stations for patients. This expands access equitably and brings care closer to where patients live and work.

6. Asynchronous Care: Telehealth is not just limited to video visits. Other valuable modalities to “deliver care at a distance” include secure messaging, e-visits, and remote symptom reporting to let patients connect with their providers without waiting for a live video encounter. This increases flexibility for patients while reducing strain on clinic schedules.

Supporting the Rural Workforce

Even when demand is high, rural clinics struggle to recruit and retain enough primary care staff. Telehealth enables new workforce models that expand clinician reach and create supportive environments for staff.

7. Telehealth-Enabled Team-Based Care: Virtual medical assistants, virtual nurses, virtual (or AI) scribes, and virtual care coordinators can join primary care teams remotely, reducing administrative burdens. This allows clinicians to work at the top of their license and serve more patients effectively.

8. Virtual Preceptors and Remote Supervision: Off-site supervisors can support trainees and early-career clinicians via teleprecepting. This strengthens the workforce pipeline and helps early-career rural providers feel less isolated in practice.

9. Hybrid Visit Models: A combination of in-person and virtual follow-ups allows rural clinicians to maintain relationships with patients while managing larger panels. This model improves efficiency without sacrificing continuity of care.

10. Work-From-Home Flexibility for Clinicians: Telehealth makes it possible for rural clinicians to see patients from home on select days, such as around weekends or when they have mild but contagious illnesses. This flexibility improves clinician satisfaction, reduces burnout, and preserves appointment availability for patients.

Integrating Care into Primary Care Practices

Primary care works best when it coordinates across the full spectrum of health needs. Telehealth can embed behavioral health, pharmacy, and care management into rural primary care practices.

Here are just a few examples:

11. Telehealth-Enabled Medication Management: Pharmacists can join primary care teams virtually to review medications and support adherence for complex patients. This reduces adverse events, improves safety, and strengthens chronic disease management.

12. Prenatal and Pediatric Hybrid Care Pathways: Expectant mothers and young families can use telehealth for prenatal monitoring, pediatric follow-ups, and lactation support. This reduces travel burdens and improves access in maternal and child health deserts.

13. Behavioral Health Integration: Primary care practices can embed teletherapy and telepsychiatry directly into visits, offering real-time consults or longitudinal care. This addresses high unmet demand and supports whole-person health.

14. Optometry Integration: Rural patients often lack access to routine eye care, leading to undiagnosed conditions such as diabetic retinopathy or glaucoma. Tele-optometry programs allow local screening with remote review, expanding preventive eye care and supporting chronic disease management without requiring long-distance travel.

15. eConsults for Specialist Access: Primary care providers can use secure eConsults to get rapid input from specialists without sending patients out of town. This model improves care coordination, reduces unnecessary referrals, and helps patients get the right treatment plan sooner, while keeping care anchored locally.

16. Virtual Care Management for High-Risk Patients: Nurses and care coordinators can conduct ongoing check-ins, coaching, and follow-up virtually. This keeps high-risk patients engaged and reduces preventable hospitalizations.

Why TelePrimaryCare Matters for the RHTP

Primary care is the backbone of rural health, but also one of its most fragile links.

These 16 telehealth solutions give rural communities practical ways to expand access, strengthen care continuity, and integrate essential services — directly aligning with CMS RHTP’s goals of improving access, outcomes, and sustainability.

Every one of these models is proven, scalable, and reimbursable, making them ready to be deployed as states design their rural health transformation plans.

Next Up in the Series: How telehealth is transforming chronic care management in rural settings — supporting proactive disease maintenance, reducing complications, and strengthening patient engagement. We’ll then turn to behavioral health, where telehealth is addressing unmet demand, expanding access points, and supporting integration across the continuum of care.

Do you want to discuss how to integrate these solutions into your state’s Rural Health Transformation Program application? Let’s chat!