The new funding will allow for more medical appointments via video in rural communities, where some of the nation’s oldest and sickest patients live.
About 15 percent of the population living in rural America includes some of the oldest and sickest patients in the country – a disparity that has been exacerbated during the coronavirus pandemic. The Biden administration is investing more in telemedicine, whose use has grown rapidly during the pandemic, as a way to improve their access to care.
Last month, the Department of Health and Human Services announced it was distributing nearly $20 million to strengthen telehealth services — medical appointments typically made by video or phone — in rural and underserved communities across the country. In. While this amount is relatively modest, it is part of a broader push to address the long neglected health care infrastructure in those areas.
Expenses include approximately $4 million To help bring primary, acute and behavioral health care directly to patients via telehealth in 11 states including Arkansas, Arizona and Maine. The money will update technology in rural health care clinics, train doctors and nurses to conduct telehealth appointments and teach patients how to take advantage of virtual appointments when they cannot see a doctor in person.
The additional $4.3 million will help provide training and support to primary care providers in rural and other disadvantaged areas through “tele-mentoring” specialists from academic medical centers, so that they can treat patients in their communities with complex conditions, such as a prolonged covid or substance use disorder.
“Telehealth expands access to care and is an important tool for improving health equity,” said Diana Espinosa, executive administrator of the Health Resources and Services Administration, an agency within the department that is distributing funds. “This funding will help drive the innovation needed to build clinical networks, educational opportunities and reliable resources to advance telehealth.”
According to the Centers for Disease Control and Prevention, rural Americans are at a higher risk of dying from heart disease, cancer, accidental injury, chronic respiratory diseases and stroke than their urban counterparts. The pandemic has also affected them disproportionately: ICU beds have been scarce during the virus surge in rural Idaho. The Navajo Nation in rural Arizona once had a higher death rate from the virus than New York City.
In August, the Biden administration provided billions of dollars to rural communities through a US rescue plan – set aside $20 million – to address virus concerns, including expanding telehealth and helping to rebuild health care infrastructure. includes doing.
Understand the Infrastructure Bill
- One trillion dollar package passed. The Senate passed a comprehensive bipartisan infrastructure package on August 10, capping weeks of intense talks and debate over the biggest federal investment in the country’s old public works system in more than a decade.
- final vote. The final tally in the Senate was 69 in favor of 30. The legislation, which will still have to pass the House, will touch almost every aspect of the US economy and strengthen the country’s response to the warming of the planet.
- Main areas of expenditure. Overall, the bipartisan plan focuses on spending on transportation, utilities and pollution cleanup.
- transportation. About $110 billion will be spent on roads, bridges and other transportation projects; $25 billion for airports; and $66 billion for the railways, providing Amtrak with the most funding it has received since its founding in 1971.
- utilities. The senators intended $65 billion to help connect rural communities to high-speed Internet and sign up low-income city dwellers who can’t afford it, and $8 billion to western water infrastructure. billions included.
- pollution cleaning: About $21 billion will be spent on cleaning up abandoned wells and mines and Superfund sites.
Other investments in rural health during the pandemic include improving training for physicians working in rural Veterans Affairs hospitals; more than $8 billion to help hospitals and doctors’ offices make up for lost revenue and increased expenses during that time; and $350 million for food, medical supplies and vaccines to rural communities.
Even though telehealth has become more mainstream during the pandemic, challenges remain. It remains inaccessible in areas without internet or proper speed. And there’s still a lot of uncertainty about how overuse of telemedicine will impact insurers and hospitals’ bottom lines over time, not to mention patient outcomes. a large body of research Supports the use of telehealth for communication and counseling and for monitoring patients with chronic conditions, but more evidence is needed on its widespread use.
The University of Mississippi Medical Center will receive more than $3.5 million out of $20 million from the Health Resources and Services Administration through two grant programs to improve health care in rural, medically underserved areas of the state, where There is widespread chronic disease and high poverty rates.
The coronavirus pandemic not only increased the need for telehealth, but also increased the amount doctors and nurses were paid to use it. Early in the pandemic, Congress and the Trump administration expanded coverage of Medicare’s telehealth services for the duration of the public health emergency, although it is unclear whether coverage will continue indefinitely.
“Now there is speed; Telehealth is now considered part of the mainstream of health care delivery,” said Dr. Saurabh Chandra, chief telehealth officer of the telehealth center at the University of Mississippi Medical Center. Permission to do telehealth was granted.”
Telehealth is not just for rural areas, Dr. Chandra said. It can be used in schools and correctional facilities as well as in patients’ homes, nursing homes, doctors’ offices and hospitals. Among other things, telehealth technology has been important for stabilizing rural COVID-19 patients as they await transfer, commonly referred to as “tele-ICU”.
The University of Mississippi Medical Center is planning to introduce such a program – essentially a two-way video system that connects critically ill patients in rural hospital ICU beds with teams of doctors and nurses that can remotely Specialists in taking care of patients.
Angela Turner-Ford, a Democratic state senator in Mississippi who chairs the state’s legislative Black Caucus, said increased access to telehealth would help medical providers tackle misinformation that was spreading among the state’s black residents. And the high commentary was causing hesitation.
If it was easier to connect with doctors on a regular basis, many hesitations might change their minds, she said.
Ms Turner-Ford said: “They are left to themselves and what someone has told them may not be reliable information.” “If you don’t have that current relationship with a practitioner, in that instance someone might know who to call to have a simple conversation.”
Jennifer Yturiandobitia, chief executive of Cornerstone Hole Healthcare Organization, a nonprofit in Boise, Idaho, focused on improving rural health care, said $350,000 it received will go toward telehealth for mental and substance abuse disorders. There is a lack of treatment for these conditions in Idaho, especially in rural areas, she said.
Ms Yturriondobeitia said her group had used telehealth in Idaho since 2015. Next, patients would go to doctors’ offices to connect with specialized providers far away. Now the focus is on connecting patients with those providers from the comfort of their homes.
In Oregon, the funding will primarily help residents of the Columbia River Gorge area. Of the six counties that will benefit, five are in vast rural areas where mountain ranges form the border between Oregon and Washington. Poverty levels are high, and for some, going to the doctor may be an hour’s drive away. About a third of the population is Hispanic.
“They don’t have enough primary care doctors, they don’t have enough mental health professionals, they don’t have enough,” said Dr. Nancy Elder, director of the Oregon Rural Practice-Based Research Network. Received $475,000.
Chronic diabetes is also widespread in this region. Dr. Elder said that one way he believes the quality of care can be improved is by enhancing the skills of doctors and nurses already out there.
The region’s award will be used for Project ECHO, a program that allows rural primary care physicians to learn from experts by video. The meetings begin with an educational presentation, followed by a discussion of the real-life clinical obstacles facing providers.
“They get access to expertise they don’t have, but they also get support so they feel less alone in challenges,” said Maggie McLean McDonnell, director of the Oregon ECHO Network and Health Education Initiatives. These patients are facing treatment.”