Access to high quality health care has been a persistent and complex challenge. And it’s one that healthcare innovators have been focused on for decades.
Progress — particularly in the notoriously slow-moving world of healthcare policy — takes time, but we stand at a unique moment of real opportunity. In the past few months, two promising changes in national healthcare policy could transform access to care for millions of Americans.
A needed opportunity for rural healthcare
To start, there’s the creation of the Rural Health Transformation Program in the recent spending bill approved by Congress, a Senate addition that establishes a $50 billion fund that states can apply to for initiatives that expand access to health care in rural areas. This focus on rural health presents a big opportunity to improve a segment of healthcare that has borne unprecedented provider shortages, funding cuts, and hospital closures for over a decade, but only if states act quickly and build on the groundwork innovators have been laying for some time.
Initiatives to expand healthcare access for rural populations have been underway for years, and among the most notable – and successful – is the introduction of virtual care. Following its stratospheric rise in popularity during and after the pandemic, telehealth has proven itself capable of helping bridge the care gaps that exist for patients seeking care in rural areas.
This is particularly true of services like primary care, urgent care, and mental healthcare, all of which can typically be conducted virtually and for which provider shortages in rural areas are well-documented; 65 percent of rural areas have a shortage of primary care physicians, and over 60 percent of rural Americans live in areas that have been designated as having a shortage of mental health providers.
Implementing virtual-first services can likewise save on costs, offering a path for states to put funds for rural health transformation to the best use. Providing team-based primary and urgent care services also allows patients to benefit from preventative treatment, reducing the need for more invasive and expensive interventions, like emergency room visits, down the line with proactive health management. Virtual options likewise provide savings for patients, both directly and indirectly, by reducing travel costs and time taken off work.
But here’s the truth: virtual care can’t do everything — and it shouldn’t try to.
Virtual care should not replace in-person care where hands-on diagnosis, procedures, or complex treatment are needed. Instead, it should serve as the on-ramp — offering rapid access, eliminating unnecessary delays, and enabling smart navigation to the right in-person resources when needed.
The key is integration — not isolation. Virtual care becomes truly transformational when it’s designed with care coordination in mind, including seamless referrals to in-network specialists, imaging, labs, and local providers. Without these linkages, virtual care risks becoming a convenient dead end.
In this era of increased demand for care, significant provider shortages, and diminishing access for rural populations, it’s essential that smart, strategic virtual care initiatives are baked into the healthcare system. But they must also be paired with robust navigation that guides patients toward in-person follow-ups and ensures continuity of care.
Virtual care can open the front door — but we must make sure the rest of the house is accessible too.
A permanent option for employers
The second big opportunity is rooted in what seems like a minor change in employer-sponsored health policy, that could in fact make primary care affordable or even no-cost for millions of Americans.
The One Big Beautiful Bill Act included the surprise permanent extension of a pandemic-era temporary relief measure known as first-dollar telehealth coverage, which allows employers to offer pre-deductible virtual primary care for those with high deductible health plans (HDHPs), which is a growing part of the population.
This means employers can implement free, direct virtual primary care and chronic disease management strategies that help people across the country get both on-demand care when they need it, and manage chronic conditions over the long term, right from their phones or tablets. With over half of all Americans receiving healthcare coverage from an employer, this change removes a key financial barrier to care and eliminates hesitation caused by policy uncertainty.
Notably, virtual-first care options open up access to interdisciplinary care for populations across the country, with free, virtual access to a diverse range of healthcare professionals, from health coaches to diabetes educators to primary care providers all included in first-dollar coverage. By cutting down on inconvenience and overcoming barriers like cost and local provider availability, telehealth encourages a team-based approach to health. This model is proven to improve outcomes for patients with chronic conditions like diabetes, while also reducing costs through reduced incidents of acute care episodes and emergency visits.
But, as with the Rural Health Transformation Fund, this policy change is only useful if it’s implemented the right way. Free is not enough — virtual healthcare must be direct, easy-to-use, high-quality, and value-based to really reach its full potential for delivering better outcomes and reduced costs.
And again, virtual services need a companion strategy: strong coordination with other benefits and in-person care options. Whether it’s scheduling a preventive screening, getting a needed mammogram, or referring a patient with severe back pain to physical therapy or orthopedic care — we must ensure that virtual care isn’t a silo.
With these opportunities promising potential for real change, this can be a big moment if the healthcare industry is ready to meet it. If we do it right, we’ll be entering a new era where healthcare is not only virtually available and affordable – but truly connected.
Photo: Philippe TURPIN, Getty Images
Dr. Cole Barfield has served as Chief Medical Officer of on-demand virtual care provider First Stop Health since 2024. As a board-certified Internal medicine physician, Dr. Barfield spent the first ten years of his career treating patients in inpatient, outpatient, and virtual primary care settings before co-founding and serving as CMO of Wellview Health, which later merged with SentryHealth before being acquired by First Stop Health in late 2023.
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