Rural households have higher rates of death, disability and chronic disease than thoses living in urban areas. The obstacles faced by health care providers and patients in rural areas are different from those in urban areas. Rural areas often have a small number of providers who cover wide geographic areas, and the nearest medical specialist or hospital may be hours away. The result is a system that often costs more and is less effective at meeting the needs of its patients. To reduce inefficiencies and improve care for rural residents, state legislatures seek innovative ways to increase access to doctors and to better coordinate care.