Improving Rural Health and Telehealth Access

The order directs the Secretary of HHS to announce a new Medicare payment model within 30 days, designed to give rural providers regulatory flexibility, predictable payments, and a path toward value-based care. It also requires HHS and the Department of Agriculture, coordinating with the FCC, to develop and implement a strategy within 30 days to improve rural physical and communications healthcare infrastructure. Additionally, it requires HHS to submit a report to the President within 30 days covering initiatives to expand rural clinical workforce access, prevent disease, reduce maternal mortality, and improve rural mental health.

Within 60 days, HHS must review telehealth and provider flexibility measures put in place during the COVID-19 public health emergency and propose a regulation to extend appropriate measures beyond the emergency period. The order does not itself change any Medicare rule, extend any flexibility, or guarantee appropriations; all operative impacts depend on future agency action, rulemaking, and available funding.

Approximately 57 million Americans living in rural communities, rural hospitals and healthcare providers, Medicare beneficiaries in rural areas, and maternal and mental health patients in rural settings. HHS, the Department of Agriculture, and the FCC are the primary directed actors.

Rural hospitals facing closure and patients who rely on them could gain more stable Medicare payment structures and expanded telehealth options. If HHS follows through with the proposed rulemaking, Medicare telehealth flexibilities introduced during the pandemic — such as virtual primary care visits — could become permanent features rather than expiring when the public health emergency ends.

All four workstreams run on parallel short timelines: HHS announces the payment model and the infrastructure strategy (with USDA and FCC) within 30 days, and submits the rural health initiatives report within 30 days. The telehealth rulemaking proposal — the only step with lasting regulatory effect — must be submitted within 60 days. The order contains standard severability language, a budget-availability caveat, and an explicit disclaimer that it creates no enforceable rights, meaning any concrete change depends on future rulemaking and appropriations.