It’s no secret that our rural communities are struggling. The headlines don’t lie—healthcare in rural America is in crisis. Today, more than 700 rural hospitals are at risk of closing, rural Americans have a 23% higher mortality rate largely due to lack of access, and approximately 80% of rural America is medically underserved. Add that to a higher population of seniors, who tend to have more health needs that are unmet, it’s clear healthcare in rural America is in critical condition. Attempts to address these issues have repeatedly fallen short and typical solutions – such as building more brick-and-mortar clinics – often miss the mark when applied to rural contexts. 

Rural Americans, like all Americans, need and deserve ongoing relationships, not episodic, transactional care, which is why we’ve seen major retail healthcare initiatives in rural communities not succeed. There is a misalignment between retail-style convenience and the need for integrated, sustainable healthcare. Care continuity is important here and the reality is retail health lacks in this area, especially when it comes to supporting older Americans with multiple chronic conditions, prescription utilization and adherence, and overall patient satisfaction. 

To really address this crisis, we need to stop believing the myths about rural America and understand what’s actually in the way. Take the myth that older Americans in rural areas aren’t capable of using technology. We’ve learned that what they fear most isn’t the technology itself, it’s being a burden to their loved ones and caregivers – a very different problem. At Homeward, we can solve this by being members’ first-line tech support when it comes to accessing virtual healthcare services. Providing personalized tech support changes the dynamic, and empowers seniors without making them feel burdensome. 

A recent Rock Health study showed an increase in virtual care adoption among rural Americans between 2020-2023, recognizing that technology is embraced when thoughtfully implemented. Throughout my career, I have seen when patients feel supported and are walked through these barriers initially they become more comfortable using virtual tools, which in turn drives greater adoption and better engagement in their healthcare journey. And, we’ve seen the real impacts telehealth can have. For example, rural programs have found that integrating telehealth into the care of older adults has helped reduce admissions to emergency services and skilled nursing facilities.

The key ingredient here? Trust. Rural communities are often skeptical of outsiders claiming to care about their needs. The distrust of outside healthcare companies is pervasive, especially during the Medicare enrollment period and when they’ve heard promises from others who have not delivered on their commitments. With so much "too good to be true" and “will you be here for the long haul?” building trust means being on the ground. Hiring locally and showing a genuine commitment to improving local care builds credibility. By combining local navigation teams with clinician support through technology, we can bridge the supply-demand divide.

Face-to-face, personal interactions in healthcare are important, but addressing the workforce shortages in rural areas cannot be solved by getting more providers to move there – it’s not a viable strategy. Rather, using a combination of local navigators and remote clinicians, supported by technology, ensures culturally competent care while overcoming the logistical challenges in rural areas. AI is the latest buzzword, but when applied thoughtfully, can make a true difference. For example, combining a provider’s local knowledge with the ability to seamlessly connect patients to social services. The seemingly small actions – such as identifying local food pantries offering low-sodium healthy foods to manage high blood pressure – can significantly improve patient outcomes and support their wellbeing, and AI enables us to tackle these problems at scale.

However, technology is not the “silver bullet.” Lasting improvements in rural healthcare require collaboration, and that’s where the second key ingredient comes in: partnership. National providers often overlook the importance of working with local health systems, yet these partnerships are critical in rural areas with struggling hospital closures. Without an understanding of the hyperlocal ecosystem, initiatives – no matter how well-intentioned – fall short of addressing the unique needs of rural communities.

For meaningful change, partnerships with local health systems are essential. At Homeward, we have taken on the role of stabilizing and supporting this fragile balance. By helping our provider partners access and win the quality incentives they’re entitled to, we create a model that doesn’t just focus on treating illness, but keeping the local healthcare ecosystem vibrant. Aligned incentives mean that everyone wins: the patient receives better, more comprehensive care, local hospitals can stay open, and the broader healthcare system, including payors, benefits from improved health outcomes and reduced emergency costs.

HLTH’s theme this year, “Be Bold,” resonates with what we’re trying to achieve in rural America. Our mission at Homeward may be bold, but that’s only because it must be – we have to take bold steps to rearchitect the delivery of health and care in rural America. Together with General Catalyst Principal Candace Richardson and Business Insider Reporter Rebecca Torrence, we're challenging the healthcare industry to rethink its approach: To invest in and build something that actually works for rural Americans.

About Amar:

Amar Kendale is the Co-Founder and President of Homeward, a company focused on improving access to high-quality, affordable comprehensive care in rural communities. His work at Homeward stems from a passion for developing products and technology that shape the future of health and improve lives.

Amar joined Livongo in 2014, shortly after its inception, as senior vice president of product management, inspired by the mission to empower people with chronic conditions to live better and healthier lives. In this role, Amar worked to deliver the market’s first integrated hardware-software-service products focused on solving the hassles of consumers living with conditions like diabetes, hypertension and more. He helped take the company through its public offering at a $3.5B valuation in 2019 and acquisition by Teladoc Health for over $18B in 2020. After the acquisition, Amar assumed the role of chief product officer at Teladoc Health, with responsibility for all telemedicine and chronic condition product lines and the unique possibilities that emerge at the intersection of the two.

Over the past 20 years, Amar has developed disruptive healthcare technology products across a wide range of domains and markets including: advanced wearables; absorbable implantable devices for the interventional device market; minimally-invasive cardiac surgery tools; and microfluidic drug discovery tools.

Amar earned both his Bachelor’s of Science and master’s degrees in mechanical engineering at MIT and has 8 issued patents.