by Arielle Zionts and Darius Tahir, KFF Health News
HOT SPRINGS, S.D. — Two of the nation’s most powerful health officials predict artificial intelligence will play a key role in solving rural America’s health challenges.
Health secretary Robert F. Kennedy Jr. told a panel of U.S. senators that AI nurses can provide “concierge care” to rural patients. Mehmet Oz, who leads the Centers for Medicare & Medicaid Services, has said “the best way to help some of these communities is going to be AI-based avatars” that connect rural patients to mental health services.
And many state health leaders agree. They are using some of their funding from the $50 billion federal Rural Health Transformation Program to expand AI among rural health organizations.
AI is computer technology that performs tasks that typically rely on human intelligence by finding patterns or generating words. It has the potential to improve the healthcare system by automating back-office work or identifying patients at risk, but several reports contend there’s little evidence AI can improve access to care and patient health in rural areas. It’s unclear how well states will track and share outcomes of the tech they invest in.
Meanwhile, some rural Americans are skeptical, according to interviews with people in Hot Springs, South Dakota, a city of about 3,400 residents at the southern end of the Black Hills.
“I get artificial intelligence for certain things, but for personal healthcare — no,” Tara Haffner said while standing outside the American Legion. Haffner said she’s worried about AI making mistakes and wants healthcare to stay between her and her doctor.
But Phillip Mues, who oversees technology at Cherry County Hospital and Clinic in rural Valentine, Nebraska, said AI is already helping clinicians save time, reduce burnout, and focus more on patient care. “I think it will help reduce burden on actual staffing,” he said. “It won’t replace people, but I think it will help in rural communities.” Still, Mues said, AI can’t fix every challenge — rural hospitals at risk of closing or ending certain services probably can’t use AI to save enough money to prevent those consequences, he said.
Congressional Republicans created the five-year Rural Health Transformation Program last summer as a last-minute sweetener to President Donald Trump’s signature One Big Beautiful Bill Act. The funding was intended to offset concerns about the outsize fallout anticipated in rural communities from the law, which is expected to reduce overall Medicaid spending by more than $900 billion over a decade.
Six people interviewed by KFF Health News in Hot Springs said the biggest problem in rural healthcare is the cost or long wait times caused by staffing shortages. Doug Nikkila, a heavy equipment operator, said AI and other technology come with benefits and risks. “If it’s not utilized correctly, it becomes a burden,” he said. Nikkila, who’s concerned about nursing home residents being neglected amid staffing shortages, said he thinks AI should send reminders to staff when their residents are due for diaper changes or other care. He also wondered whether AI-powered video monitors could send alerts when they detect falls or illness symptoms.
The healthcare industry is rapidly adopting AI despite the tools being “poorly evaluated,” according to a recent report from ARISE, a Stanford- and Harvard-led group that evaluates health-related AI. The report says that while some AI has been successful in controlled settings, there’s less evidence it can perform in the real world.
This story was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. Learn more about KFF Health News.