By: Julia Burleson and Leila Sullivan
Join us at 1pm ET on February 13 for a virtual discussion on how state policymakers can better support mobile health clinics and improve access to care. Register here.
Hundreds of rural hospitals across the country are operating on thin margins, and recent federal policy proposals threaten to exacerbate that strain. Provisions in H.R. 1 are projected to reduce federal funding to hospitals and other providers by more than $1 trillion, putting many rural facilities at risk of service reductions or closure. In an attempt to mitigate some of these challenges, H.R. 1 established the Rural Health Transformation Program (RHTP), allocating $10 billion annually over five years to assist states in modernizing rural health care infrastructure, expanding access to care, and improving patient outcomes.
To access this funding, states submitted applications to the Centers for Medicare & Medicaid Services (CMS) describing how they intended to use RHTP funds. The RHTP Notice of Funding Opportunity explicitly identified mobile health as an allowable use of funds to support population health infrastructure, rural health networks, and remote (non-clinic) care services. Given this guidance and our recent literature review documenting the effectiveness of mobile health delivery in expanding access to rural areas, we reviewed state RHTP applications to identify whether and how states are planning to incorporate mobile health into their rural delivery systems.
We found that as many as 42 states included mobile health in their applications. With awards announced for all states in late December 2025, states are in a critical pre-implementation phase. Early decisions about how mobile health initiatives are designed, financed, and integrated could shape their long-term effectiveness in expanding access and strengthening rural health care delivery.
Effectiveness of Mobile Health in Improving Rural Health Care Access
Our research indicates that mobile health models can expand access to care in rural communities by reaching populations facing geographic and broadband barriers. Mobile health care can increase preventive care, support chronic disease management, and link patients to follow-up care. For instance, a program in rural Minnesota launched a mobile-telehealth hybrid model, allowing patients to avoid 30–60 mile trips for primary care.
Patients frequently report high satisfaction with the convenience and quality of mobile health services in rural areas. Some programs are also associated with reduced emergency department use and potential system-level cost efficiencies. For example, a rural South Carolina community paramedicine program helped patients lower their blood pressure and blood glucose levels while also reducing emergency department visits.
The sustainability of mobile health programs often depends on stable funding, strong community partnerships, and referral networks that allow mobile services to act as a gateway to additional care. In rural Tennessee, a mobile health program stationed the vehicle alongside a community mental health center on certain days to provide primary care for patients receiving mental health care. The program also used telehealth to connect rural patients with specialty providers and was planning to sustain operations by billing for services. These findings provide a useful lens for understanding the variety of mobile health initiatives proposed in RHTP applications and how states envision them supporting broader rural health strategies.
Mobile Health in RHTP Applications
State RHTP applications offer insight into how states intend to deploy mobile health and highlight areas where additional operational planning may be needed. Across RHTP project narratives, 42 states proposed mobile health initiatives across eight models defined by service-type: Primary care (including maternal care), vision, dental, mental health and medication for opioid use disorder (MH/MOUD), mammography, stroke response, behavioral health crisis response, and community paramedicine/mobile integrated health (CP/MIH). While some states included plans to support multiple mobile health models in their applications, others focused on single models such as primary care or behavioral health. Table 1 summarizes the mobile health models proposed in RHTP applications.
Although mobile health appeared in most applications, states varied considerably in the level of detail they provided about how funds would be used to support implementation. Most states offered generalized descriptions of the services mobile programs would provide, without detailing the operational and financial considerations required for sustainability. In contrast, a few states described concrete plans, such as building telehealth infrastructure into mobile units, developing the rural workforce through hands-on training experiences for students, integrating mobile units with existing health systems, and establishing billing infrastructure to support financial sustainability. This distinction matters. States hoping to integrate mobile health into rural delivery systems must engage in significant operational and financial planning to successfully move from concept to implementation.
Table 1: Summary of Mobile Health Models in RHTP Applications
| Mobile Health Models | Number of States | States |
| Primary Care | 22 | AL, AZ, AR, CT, DE, FL, GA, ID, IL, IA, MA, MN, MT, NH, ND, OR, PA, RI, UT, VA, WA, WI |
| CP/MIH | 20 | AK, CT, FL, IN, IA, KS, MD, MA, MO, NH, NM, OH, RI, TN, UT, VT, VA, WA, WV, WI |
| MH/MOUD | 18 | AK, AZ, AR, DE, FL, GA, ID, IL, MI, NH, NC, ND, OR, RI, UT, VT, WA, WI |
| Dental | 15 | AK, CT, DE, FL, GA, KY, MN, NH, ND, OH, OR, PA, RI, VT, WI |
| Behavioral Health Crisis Response | 12 | AZ, CT, ID, KY, MD, MI, NC, OH, SD, TN, WA, WI |
| Cancer Screening | 10 | AL, DE, FL, GA, ID, KS, MD, MN, NC, ND |
| Stroke Response | 1 | FL |
| Vision | 1 | OH |
| Unspecified | 9 | CO, LA, ME, MT, NV, NJ, ND, TX, WV |
Source: Author’s Analysis
Spotlighting Standout Mobile Health Initiatives
Across the three states highlighted below, several common themes emerge: Each program integrates mobile care into existing rural health systems rather than treating it as a standalone, grant-dependent service. All three leverage Medicaid, Medicare, and commercial reimbursement to support ongoing operations and emphasize workforce development to ensure mobile teams can deliver care effectively. Telehealth connections and referral networks are also commonly included to link mobile services to broader health systems, creating continuity of care and expanding access for patients in rural communities.
Arizona focuses on relieving strain on rural hospitals and emergency departments. Mobile clinics and community paramedics provide preventive, diagnostic, maternal, chronic disease, and physical rehabilitation services directly in rural and Tribal areas. By integrating mobile services into existing hospitals and Federally Qualified Health Centers (FQHCs) and relying on reimbursement from insurers, Arizona expects to reduce avoidable emergency department visits and hospitalizations. Workforce development and coordinated care further enhance efficiency and long-term sustainability.
Arizona’s RHTP application and press release.
Florida emphasizes telehealth integration and community paramedicine. Mobile units provide preventive screenings, diagnostic services, prenatal care, and rehabilitation, while community paramedics deliver in-home follow-up and chronic disease management. These services are connected through telehealth hubs and the Florida Health Information Exchange, allowing patients to access specialists and maintain continuity of care. Traveling units visit schools, senior centers, and community hubs, with paramedics supporting care outside traditional facilities.
Florida’s RHTP application, website, and press release.
Minnesota stands out for its integration with Tribal health organizations and its focus on dental and primary care. Mobile medical and dental units provide preventive screenings, basic primary care, restorative dental services, and lab work, while telehealth links patients to specialty care. The state also positions mobile units as extensions of FQHCs and community clinics, embedding care within existing referral networks and using community sites such as schools for service delivery and workforce training.
Minnesota’s RHTP application and press release.
Looking Forward
Historically, mobile health has often functioned as a peripheral or grant-dependent intervention rather than as a core component of health care delivery. The RHTP presents an opportunity to elevate mobile health from an ad hoc solution to an established component within rural health systems. Realizing this potential will require thoughtful integration of mobile services into existing delivery and payment structures, including durable pathways for financial sustainability. Many states plan to use mobile health services, and looking at the approaches highlighted in the state examples can offer valuable guidance on how to embed mobile care into rural delivery systems while supporting long-term financial stability. If states use the current pre-implementation period as a planning runway for these structural changes, the RHTP could help solidify mobile health as a lasting and valuable component of rural health care delivery and the broader health system.
The authors are research faculty at the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy. Their time and research related to this article was supported by a grant from the Leon Lowenstein Foundation.
