Given the large variation of population health indicators throughout rural America, there are some rural counties whose population health metrics reflect the clustering of low socioeconomic status, adverse health behaviors, limited access to healthcare, and poor environmental factors. In this brief, we demonstrate a simple selection process that allows a user to identify these rural counties with the greatest health needs using publicly available, population health indicators in the context of the existing safety-net infrastructure. While there are many appropriate methodologies one could use to identify communities with limited access to healthcare and high health needs, we describe an approach that uses a range of different factors including geographic isolation to help policymakers identify rural communities that could benefit from expansion of the safety-net system.