Americans living in rural areas face a shortage of primary care physicians and specialists, and often must travel large distances to obtain medical care. The increasing cost of providing health care and the demands of an aging population also put pressures on rural health care providers, many of which struggle to keep their doors open. The Federal Communications Commission (Commission or FCC) has implemented the statutory mandate for universal service by, among other things, creating the Rural Health Care (RHC) program to improve access to communications services for eligible health care providers. In recent years, broadband has become increasingly vital to the effective delivery of health care, and it can be uniquely transformative in rural areas, where distance poses a substantial challenge. In recognition of this, the Commission in 2006 launched the Rural Health Care Pilot Program (Pilot Program), which awarded 69 projects one-time funding for a defined period of time (a total of $418 million) to cover up to 85 percent of the cost of construction and deployment of broadband networks that connect participating health care providers in rural and urban areas. The Pilot Program currently supports 50 active projects in 38 states (the "Pilot projects") and the territories of Guam, American Samoa and the Northern Mariana Islands. Many of the Pilot broadband networks have been established and are now delivering the benefits of telemedicine and other telehealth applications to their patients. In creating the Pilot Program, the Commission sought to harness the potential of broadband health care provider networks to improve the quality and reduce the cost of health care in rural areas, while drawing on that experience to inform the redesign of its permanent RHC program. A key component of any pilot program is the opportunity to evaluate what has been learned and how those experiences can inform future work - in this case, the Commission's ongoing oversight and management of its universal service programs. This Staff Report provides an evaluation of the successes and challenges of the Pilot projects to date. The Report describes the projects, their broadband networks, and the financial and telehealth benefits generated by their broadband connectivity. The Report presents data through January 31, 2012, except where otherwise noted. This Report also summarizes key observations from the Pilot Program, to assist the Commission as it considers potential changes to the permanent rural health care program. In the 2010 Notice of Proposed Rulemaking (NPRM), the Commission proposed a number of changes to improve access to broadband services and broadband infrastructure for health care providers, building on the recommendations of the 2010 National Broadband Plan. As is clear from this Report, the Pilot Program provides fertile ground to help the Commission determine how best to reform the existing rural health care program, which provides ongoing support for telecommunications and Internet access services. The following are key facts, benefits, and lessons of the Pilot Program to date: