Health systems unite to close specialty care gap in rural America

More than 20 major U.S. health systems have teamed up to create a coalition to address healthcare gaps in rural and underserved communities. The National Specialty Care Access Coalition (NSCAC) brings together health systems, clinicians, technology partners, and policy stakeholders to focus on new models, including access to specialty care through virtual platforms. The aim of the coalition is to bring leaders together to move beyond fragmented solutions and define scalable, outcomes-driven approaches to specialty care access nationwide.

“Access to specialty care should never depend on a patient’s ZIP code, income, or background. Advancing health equity requires coordinated, systemic action,” Amy P. Murtha, M.D., dean of Rutgers Robert Wood Johnson Medical School, said in a news release. “Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School are proud to stand with the National Specialty Care Access Coalition to dismantle barriers, expand access, and ensure every community receives the expert care it deserves.”

Nearly 20% of Americans live in rural areas, while only about 9% of physicians practice there, leaving many rural hospitals without reliable access to core specialties such as neurology, cardiology, maternal fetal medicine, critical care, dermatology, and surgery. Similar shortages affect underserved urban communities, where demand for specialty care continues to far exceed available capacity.

The coalition is convened and chaired by Chethan Sathya, M.D., director of Northwell Health’s Center for Gun Violence Prevention, and Rajiv Narula, M.D., founder and CEO of Sevaro Health, which has developed an AI decision-making tool for neurologists.

The new coalition has three initial priorities:

• standardizing care models, including multispecialty care pathways for rural hospitals
• advancing policy reform, including producing a white paper on recommendations to CMS and state Medicaid agencies to modernize reimbursement, licensing and regulatory frameworks in both virtual and network-based specialty care, and
• accelerating implementation, including pilots in neurology, cardiology, maternal-fetal medicine, neonatology, critical care, and chronic disease management.

“By collaborating with peer institutions, we can accelerate solutions that overcome longstanding barriers to access, workforce capacity, transportation, cost, and equity," said Kevin M. Curtis, M.D., medical director, Dartmouth Health Connected Care and Center for Telehealth. “As one of the most rural health systems in the country, Dartmouth Health has long leveraged telehealth to connect patients with the care they need.”

The health systems are also working with experts from the Center for Telehealth and eHealth Law and technology collaborators that work across rural communities, such as T-Mobile, Sevaro Health, and Samsung, to support its infrastructure work.

The coalition launch comes after CMS announced in December 2025 that all 50 states will receive awards under the Rural Health Transformation Program. In 2026, states will receive first-year awards averaging $200 million, within a range of $147 million to $281 million, to expand access to care in rural communities, strengthen the rural health workforce and modernize rural facilities and technology.

In total, the CMS effort will provide $50 billion over five years, with half going to the states and half allocated based on individual state metrics on rural health. The Rural Health Transportation Program was part of the One Big Beautiful Bill that was passed in July 2025.