Although it’s been around since at least the mid-1990s, telehealth has been slow to catch on before this spring, said Mei Kwong, executive director for the Center for Connected Health Policy. Before COVID, only 19 states’ Medicaid programs covered remote patient visits originating from the home, according to the center’s most recent 50-state survey. Fewer than half covered remote patient monitoring and only 16 reimbursed for store-and-forward care. FIND STATE-BY-STATE PRE-COVID POLICIES
Since March, there have been a flurry of changes to federal and state policies regulating virtual consultations as governors, legislators and insurance commissioners rushed to remove barriers to telehealth. Common changes temporarily expanded the types of providers, services, technologies and locations of telehealth visits covered by state Medicaid rules and eased licensing rules for out-of-state providers during the public health emergency.
ByClaire Hettinger and Pam Dempsey/Midwest Center for Investigative Reporting |
With farmers facing increasing stress and depression, Midwestern states and national farm groups are making more efforts to better provide services to alleviate the high rate of suicide among the agriculture industry. Yet in rural areas, this care is more of a challenge. Rural hospitals — often the primary source of health care services in these areas — are closing or merging. Since 2010, 23 hospitals have closed across the Midwest — a loss of nearly 1,000 beds, according to the North Carolina Rural Health Research Program.
An Institute for Nonprofit News investigation by 12 news outlets across seven states found that rural Midwest hospitals have reduced services or merging with larger health systems in an effort to deal with financial and regulatory pressures. Only two of those Midwestern hospitals were in Illinois, but accessing mental health services in rural communities remains difficult. Some groups have decided to address the situation themselves.
A collaborative project including the Institute for Nonprofit News and INN members IowaWatch, KCUR, Bridge Magazine, Wisconsin Watch, Side Effects Public Media and The Conversation; as well as Iowa Public Radio, Minnesota Public Radio, Wisconsin Public Radio, The Gazette (Cedar Rapids, IA), Iowa Falls Times Citizen and N’west Iowa REVIEW. The project was made possible by support from INN, with additional support from the Solutions Journalism Network, a nonprofit organization dedicated to rigorous and compelling reporting about responses to social problems. For more stories visit hospitals.iowawatch.org
For example, the organization GROW sets up meetings over Zoom, a video conferencing app, to help those in rural areas experiencing mental health issues.And more than a dozen farm bureau managers in Illinois have taken mental health first aid classes that help people recognize signs of distress. Harry Brockus — the chief executive officer of Carle Hoopeston and Carle Richland in Central Illinois, a collection of hospitals that serves 41 mostly rural counties — said there is a physician shortage across the country and recruitment to rural areas is an even bigger challenge.
“We do not offer the amenities that physicians are looking for,” he said, “such as shopping, schools and different entertainment venues.”
Other challenges in rural areas, such as transportation, housing and access to healthy food, can make rural healthcare costs inefficient and unaffordable, Brockus said.
This has left rural America in a bind when it comes to care for mental health.
A seven-state news investigation revealed plenty of problems facing rural patients but also a variety of creative attempts to solve them. The head of the National Rural Health Association puts it this way: “Everyone realizes we’re at a crisis point.”
ByChelsea Keenan, IowaWatch; Sara Konrad Baranowski, Iowa Falls Times Citizen; Natalie Krebs, Iowa Public Radio; Mark Mahoney, N’west Iowa REVIEW and Michaela Ramm, The Gazette |
Hospital leaders say a policy fix is needed to ensure the future of rural hospitals in Iowa and across the country that are succumbing to financial pressures and closing their doors. Until that fix comes, though, Iowa’s network of rural community hospitals is making tough choices and smart partnerships to get by, a series of interviews by Iowa news organizations collaborating with IowaWatch revealed. Some have dropped OB-GYN services. Smaller hospitals have turned to larger ones to form partnerships, which can
result in the elimination of services to be more cost-efficient but forces
patients to drive out of town for health care. Other efforts to maintain local
hospital care include shifting to more outpatient care, the interviews show.
Last year, according to a University of Missouri survey, dicamba damaged an estimated 3.6 million acres of soybeans across 25 states when it drifted from farms planted with seeds genetically engineered to resist the chemical onto regular soybean fields.