What’s the issue?

People in rural communities often face serious barriers to care — few providers, long travel times, and limited support for chronic and behavioral health care needs. These gaps reflect broader health system challenges, including workforce shortages and underfunded services. Tech-enabled innovations can help mitigate these challenges, but rural areas often lack the financial resources, infrastructure, and digital access needed to fully leverage these tools.

The Medicaid connection.

Historically, private sector tech innovation has focused more on commercial and Medicare markets than Medicaid. In recent years, however, state Medicaid agencies and their managed care organization (MCO) partners have increasingly tested tech-enabled solutions to expand access, improve care coordination, and support more efficient use of limited health care resources, including in rural communities.

How can tech-enabled solutions support priorities of the Rural Health Transformation (RHT) Program?

States can leverage tech-enabled solutions to support the RHT Program’s tech innovation priority. Investments in these solutions align specifically with the RHT Program consumer tech solutions category, but can also support most other categories as well.

Opportunities and examples.

There are a wide range of tech-enabled solutions that show promise for supporting Medicaid populations and addressing the challenges faced by rural providers. While not all have been rigorously evaluated given the rapidly evolving nature of this field, many show promise in improving access, care coordination, and health outcomes. The following examples are intended to illustrate potential approaches that states may consider — not as endorsements or proven models — but, as innovations worth exploring in the context of rural health care delivery.

• Improving efficiency and reducing administrative burden. Many rural providers operate on thin margins, with limited resources. One example of a tech-enabled solution that can address these resource gaps is ThriveLink, an AI-powered telephonic benefits enrollment program that signs people up for health insurance, food stamps, and utility assistance. They have partnered with health plans and health systems in rural California communities to simplify the benefits enrollment process for individuals and improve administrative efficiency. Abridge, an AI-based tool that transcribes clinical notes within existing electronic health records, can help streamline administrative tasks, reduce errors, and enable providers to focus more on patient care. Abridge has been implemented in FQHCs and safety net health systems across the country.
• Enhancing care coordination and patient engagement. Tech platforms can simplify patient engagement and coordination across providers and health plans, as well as improve the care experience for patients. For example, Reema Health uses text messages to check in and follow up with high-risk Medicaid recipients while maintaining an up-to-date log of their care team and medical history. They partner with MCOs across 11 states, including states with large rural regions.
• Expanding and supporting the health care workforce. Tech-enabled solutions can improve recruitment, retention, and training for providers. Arc Health, for example, is an online staffing service that connects physicians and nurses to high-need rural or tribal health care facilities.
• Improving chronic disease management. Digital health platforms can enable consistent patient engagement, data tracking, care coordination, and direct interventions to support chronic disease management. Omada Health is an app for people with prediabetes, diabetes, and hypertension that connects to smart devices (e.g., blood pressure or continuous glucose monitors) to provide personalized care plans and health coaching. The platform may support access to care for people facing barriers to in-person care and has successfully engaged patients with low-incomes, leading to weight loss among participants with prediabetes. FarmboxRx is a member engagement platform that partners with health care organizations to deliver customizable nutrition solutions. Coupled with home-delivered produce boxes and tailored health-related action steps, FarmboxRx has demonstrated improved outcomes for Medicaid members with chronic conditions like diabetes, obesity, and heart disease in rural Kentucky, Tennessee, and New Mexico, among other states.
• Expanding access to opioid treatment. Telehealth solutions are extending care to rural residents without nearby treatment options. Sonara Health provides an app that enables remote methadone dosing and ongoing engagement with care team members. Opioid treatment is particularly challenging in rural areas where people may need to travel long distances to methadone clinics for care. Boulder offers virtual addiction treatment, case management, and prescriptions to suboxone. The Boulder platform was recently piloted in rural Oregon.

Key considerations for implementation.

Technology-enabled health care solutions face common implementation challenges related to sustainable funding, systems integration and data interoperability, and broadband access. Additionally, the solutions highlighted in this tip sheet represent only a small set of options available to Medicaid agencies. States should clearly define the challenges they aim to address and identify solutions that best fit their local context and infrastructure capacity. In supporting tech innovations, states with Medicaid managed care can also collaborate with MCOs to understand existing solutions implemented at the plan level and opportunities for alignment across plans.

Potential impact.

Evidence is emerging that tech-enabled innovations can improve outcomes and reduce costs, but many solutions remain relatively new and lack robust evaluation. In selecting among available tech-enabled solutions, states can conduct formal vetting processes and prioritize technologies with demonstrated impact, particularly those tested in rural settings and among Medicaid populations.

What’s next?

States interested in implementing technology-enabled innovations in rural areas can take several steps to ensure that solutions are practical, effective, and sustainable by: (1) engaging rural providers and communities to identify their most pressing challenges; (2) using these insights to source solutions tailored to local needs; (3) assessing solutions already being used in similar rural communities that could be adapted or scaled; (4) reviewing evidence on effectiveness; and (5) piloting solutions to determine what works locally and identifying mechanisms for long-term sustainability.

Additional resources for more information:

• Medicaid Innovation Collaborative – Brings together stakeholders across the Medicaid ecosystem to advance the adoption of technology-enabled solutions. The program offers resources and insights gained from partnerships with Medicaid departments, MCOs, and entrepreneurs, highlighting effective tech solutions that support Medicaid priorities. (Acumen America)
• Tech-Enabled Innovation in Medicaid Managed Care: Medicaid Innovation Collaborative Case Studies – Describes partnerships between MCOs and technology companies to test innovations that address health-related social needs and support accessible, patient-centered care. (Center for Health Care Strategies, 2025)
• Examining AI and Health Care: Implications for Equity and California’s Health Care Safety Net – Explores the opportunity and challenges of using AI in health care, including supporting high-quality care through Medicaid. (California Health Care Foundation, April 2024)
• Telehealth Evolution in California Progress, Challenges, and Opportunities and Advancing Access to Telehealth in California Recommendations for Policymakers – Describes the growth of telehealth adoption in California and outlines recommendations for how policymakers in California and across the U.S. can further support the use of telehealth to improve care access and reduce health disparities. (California Health Care Foundation, January 2025)