Health access that reaches beyond city limits

Yet, the definition of “rural workforce” has expanded considerably in the post-pandemic era. As remote and hybrid work arrangements have become standard, companies across nearly every industry have extended job offers without geographic restrictions — and a growing share of those new hires live in small towns and rural communities, far from the urban centers where their employers are based.

While good for attracting a more expansive talent pool, rural communities often face a set of structural challenges that can affect access to care: persistent provider shortages and hospital closures.³ The result could lead to a workforce segment that delays preventive care, struggles to manage chronic conditions and ends up needing costlier, more intensive interventions — all of which land squarely on an employer's balance sheet.

Understanding the depth of this challenge and the innovative strategies to address it is essential for any benefits leader designing a plan that works for the whole workforce.

Provider shortages, hospital closures and insufficient infrastructure leave rural residents with far fewer local treatment options than their urban counterparts.³ Faced with long drives for routine checkups and the prospect of missing work for medical appointments, employees are more likely to delay preventive care or wait until minor ailments become serious, which often comes with higher price tags. In fact, studies show rural residents tend to have fewer annual visits with health care clinicians,⁴ experience worse overall health outcomes and have shorter life expectancies than individuals living in urban areas.⁵

The remote work era has made this dynamic unavoidable for benefits leaders. A company that expanded its talent pool nationally over the past several years may now have dozens, hundreds or even thousands of employees enrolled in its commercial health plan who live in rural ZIP codes with limited local network options. That makes network adequacy and access — not just cost — a critical plan evaluation criterion.

For employers, deferred care translates directly to higher claims costs. Preventable hospitalizations, emergency room visits and late-stage disease management are significantly more expensive than the primary and preventive care that could have addressed these issues earlier. They also drive absenteeism, reduce productivity and accelerate turnover — compounding costs well beyond the medical claim itself. Similar challenges can affect prescription medication use. When employees face barriers to filling or refilling medications, adherence may decline, potentially leading to worsening chronic conditions, avoidable emergency care and higher overall health care costs.

Acute care access adds to the problem. Since 2005, nearly 200 rural hospitals have closed or discontinued inpatient services, and more than 700 are currently at risk of closure.⁶ As local hospitals shutter, employees may face even longer distances for emergency and specialty care.

When team members live in underserved areas, their health and well-being directly affect the productivity, retention and health care costs of the entire organization. Businesses that proactively invest in solutions — through smart plan design, innovative partners and the right technology — are better positioned to protect both their workforce and their financial performance.

Technology-enabled access is a meaningful lever for bending the cost curve and improving outcomes across a distributed workforce.

Virtual visits expand the provider network beyond geography. Through telehealth, employees gain 24/7 access to provider visits from their home or workplace, eliminating the barriers of long drives, missed shifts and childcare arrangements. Many UnitedHealthcare commercial benefit plans include virtual visits with primary care providers, specialists and therapists, as well as round-the-clock urgent care access through a national provider network. When medications are prescribed, enabling the delivery of the medication directly to the employee's home can remove yet another access barrier for rural workers. Mail-service pharmacy options can help employees avoid potentially lengthy travel to a retail pharmacy, support medication adherence and continuity of care. For employees managing chronic conditions, convenient medication access may help reduce gaps in treatment that can contribute to avoidable complications and higher downstream costs. For HR and benefits teams managing a nationally distributed workforce, the depth and reliability of a carrier's virtual care network matters as much as the in-person network.

Digital tools help close the behavioral health gap. According to 2025 data, 137M Americans, or roughly 40% of the U.S. population, live in a federally designated Mental Health Professional Shortage Area.⁷ This is making sustained behavioral health support difficult to access and easy to forgo. For employers, untreated behavioral health conditions are a known driver of absenteeism, disability claims and reduced productivity.⁸ Digital, self-help resources have helped fill this void, using clinically validated approaches to deliver support for lower severity conditions, such as the Calm Health app or in-the-moment support, or behavioral health coaching. Options like these may help reduce the reliance on in-person therapy sessions for less severe behavioral health situations.

One important infrastructure caveat: The effectiveness of these technological tools depends on reliable broadband and cellular connectivity. Employers with large rural or remote-work populations may want to factor internet access into their workforce well-being strategy and advocate alongside industry coalitions for public investment in high-speed infrastructure that makes virtual care viable at scale.⁵

Where facilities have closed and physicians are scarce, new care delivery models are emerging — and forward-thinking employers are building them into their benefits strategy.

Mobile health clinics bring primary care directly to employees. Roughly 3,000 mobile health units operate across the U.S., providing screenings, vaccinations and chronic disease management for conditions like asthma and hypertension — which, left untreated, drive significant claims costs.⁸ UnitedHealthcare works to ensure covered services on mobile units are reimbursed at rates comparable to brick-and-mortar settings. Employers should confirm their carrier's reimbursement policy during plan evaluation.

Pharmacy-based telehealth hubs are turning the rural community's most accessible touchpoint into a full care experience. More than 8 in 10 Americans live near a local pharmacy, which is far closer than most rural residents live to a clinic or hospital.⁹ UnitedHealthcare works with networks that equip local pharmacies with private consultation spaces and connected devices, which may enable testing, virtual clinical consultation, treatment recommendations, medication dispensing and vaccine administration through a coordinated care experience.

Pharmacists can also play an important role in supporting medication education, adherence and coordination of care. For employees managing chronic conditions such as diabetes, hypertension or asthma, regular pharmacist engagement may help address barriers before they result in more serious health complications.

Community-based initiatives like those UnitedHealthcare has launched across various cities through its Communities of Health are helping address gaps and provide community members with greater access to care. Using data analysis and community insights, UnitedHealthcare is identifying at-risk communities and putting centers in place that target top local health challenges. Community-based initiatives are vital for rural health because they harness local trust, partnerships and resources to improve access to care, address social drivers of health like transportation and nutrition, and tailor interventions to the specific needs of rural communities. By empowering residents and fostering collaboration among local organizations and health care providers, these initiatives drive greater uptake of preventive care, earlier disease detection and sustained long-term health outcomes.