Abstract: The planning, design, funding and delivery of quality, contemporary health care is universally a complex and challenging task. This is irrespective of setting, community and population characteristics, economic circumstances and individual health status. In rural and remote Australia the complexity is magnified by unique characteristics and challenges. These necessitate the development and application of a dedicated framework which supports a nationally coordinated approach that is also adaptable to local conditions. Health care planning, programs and service delivery models must be adapted to meet the widely differing health needs of rural communities and overcome the challenges of geographic spread, low population density, limited infrastructure and the significantly higher costs of rural and remote health care delivery. In rural and remote areas, partnerships across health care sectors and between health care providers and other sectors will help address the economic and social determinants of health that are essential to meeting the needs of these communities.