Indiana is embarking a new way to deliver mental health care to Medicaid members. John Wernert, M.D., a psychiatrist who heads Indiana’s Medicaid agency, is introducing telemedicine to deliver psychiatric and other mental health services to patients, including the approximately 85 percent of patients who have what he calls rather modest behavioral health needs.
Indiana’s telemedicine initiative is important because the state is one of only a few adopting telehealth statewide. More widespread use of telehealth has been slow due to concerns about costs, as Phil Galewitz reported for Kaiser Health News last month. Continue reading
Photo: Pia Christensen/AHCJMedical student Russell Stanley (left) and Dr. Kevin Blanton (right) share the stresses and triumphs of providing care in rural settings at AHCJ’s June 19 Rural Health Journalism Workshop.
Distance dominated much of the conversation at AHCJ’s recent Rural Health Journalism Workshop in Fort Worth, Texas, a vast state with wide open spaces and far-flung cities.
While such expanses can offer a quiet alternative to urban areas, panelists at #ruralhealth15 also noted that such isolation can impact not only health, but education and other community resources. And that can present another challenge: attracting health professions to rural pockets to provide needed care for residents. Continue reading
Photo: Len Bruzzese/AHCJMore than 70 people attended AHCJ’s Rural Health Journalism Workshop on June 19 in Fort Worth, Texas.
At a glance, the Dallas-Fort Worth area doesn’t seem so remote. Touching down in northern Texas, there’s a glut of restaurants, a Starbucks (there’s always a Starbucks) and, soon, a maze of highways.
But head from the airport to AHCJ’s Rural Health Journalism Workshop (#ruralhealth15) in downtown Fort Worth, and one of the major health care challenges facing non-urban areas quickly becomes clear: distance. On the road from Dallas to Fort Worth stretch miles of pavement. One Texas injury clinic along the way doesn’t look much different than the auto shops and loan stores it is sandwiched between along the busy route.
In fact, this metropolitan region was the model setting for the more than 70 people who attended the daylong program – a vast state with many isolated pockets close to Oklahoma and other states with similar challenges that can put rural residents at the bottom rung of the U.S. health care system. Continue reading
A lot has been made of mapping health care lately, from states and counties to ZIP codes and income. But take a step back, and a lot of the issues facing health care writers and policymakers are part of the nation’s larger rural-urban divide.
The Association for Health Care Journalists is offering a chance on June 19 for health writers to explore what is happening in America’s less populated areas as well as the emerging trends at its Rural Health Journalism Workshop. Continue reading
Kentucky, a southern state implementing the ACA, has gotten a fair amount of media attention and we’ve highlighted some of the coverage.
But, in impoverished rural areas that stood to gain the most from the greater access to care that the ACA promised, many residents remained fiercely opposed to the law and the president who pushed it.
Against this backdrop, a team from USA Today and The (Louisville, Ky.) Courier-Journal decided to launch an in-depth examination of how the law is beginning to play out in Appalachian Kentucky.
In an article for AHCJ, Courier-Journal medical writer Laura Ungar writes about how the team tackled the issue, combining local and national perspective and expertise. Read more.
Along with coverage of everything from Congressional wrangling over the Farm Bill to livestock management to wildlife conservation, High Plains/Midwest Ag Journal’s senior field editor Larry Dreiling finds time to tackle health stories. He sees access to health services as essential to sustaining rural life.
His neighbors in rural America may live many miles from a needed specialist or emergency room. Or, as he points out, they may need to drive two hours to get to a dentist.
Dreiling was kind enough to take some time recently to talk about his coverage and to offer advice to other reporters about telling health care stories in rural America.
Rural health leadership in a changing countryside
Tina Castañares, M.D.
Seeing rural health problems downstream – with people thrashing for help in a metaphorical river’s rapids – is one perspective. But our luncheon speaker, with almost 30 years of experience in Oregon public health, primary care, public policy and philanthropy, will tell her own stories of rural health looking upstream, where the problems can begin.
Attend AHCJ’s free Rural Health Journalism Workshop for a better understanding of what’s happening – or will be happening – in rural regions, and return to work with dozens of story ideas you can pursue.
Compared with city dwellers, people in rural America have higher rates of cancer, diabetes, disabling injuries, and other life-shortening health problems.
Among the less talked about aspects of the Affordable Care Act are measures intended to help reduce rural health disparities. But health professionals working in remote small towns aren’t convinced that the well-intentioned steps will bring enough relief – and do it quickly enough – to reverse problems that many fear are getting worse, such as lack of economic opportunity for rural residents, and limited access to high-quality medical clinics and hospitals.
“There’s definitely joys, but right now the change is huge. It’s going to make it hard for many of us to survive,” said Dean Bartholomew, M.D., a family medicine physician in Saratoga, Wyo., a town with 1,700 residents that is nearly an hour’s drive away from the nearest hospital. Bartholomew was among the panelists at the Health Journalism 2014 session on rural health.
Rural health difference
For Bartholomew, the joys include the rich relationships he’s been able to build with patients and the community. He’s found himself serving as the volunteer team physician for the local high school, for instance, and taking care of sick pets on occasion. Continue reading
“Health reform” is the term we use to describe the changes being made to the U.S. health care system under the Affordable Care Act. But as we’re reminded from time to time, for example in a blog post by Austin Frakt earlier this month at The Incidental Economist, the ACA is more accurately defined as health insurance reform.
Certainly insurance reforms are badly needed, but these reforms alone are doing little to reform the actual delivery of care to patients. Jim Doyle, who covers the health care industry for the St. Louis Post-Dispatch, makes this point in on a series on health care access and the fraying safety net.
In a new “How I Did It” article, Doyle explains what he found when reporting from rural parts of Missouri and Arkansas is that, while the Affordable Care Act will bring changes to the health insurance marketplace in these areas, it only goes so far in helping the poor access health care services. Continue reading
Conan Murat, one of Alaska’s first dental health aide therapists, provides a first-person perspective on providing oral health care to his fellow Native Alaskans on the isolated Yukon-Kuskokwim delta in this month’s issue of Health Affairs.
One of the perks of belonging to the Association of Health Care Journalists is free access to online versions of a number of useful journals. Health Affairs is one of those and the November issue is dedicated to the theme of “Redesigning the Health Care Workforce.”
In one piece, “How to Close the Physician Gap,” the authors suggest that registered nurses and pharmacists could help address the disparity between the demand for primary care services and the number of physicians available to provide the care. Another looks at meeting growing health care needs through the wider use of nurse practitioners and physician assistants.
But Murat’s piece weighs in on another health care workforce issue that touches the lives of millions of Americans: the shortage of dental providers. Continue reading
In rural areas, the federal Centers for Medicare & Medicaid Services designates more than 1,300 hospitals as being “critical access hospitals.” So designated, these facilities get a bit more in reimbursements to ensure that Americans outside of cities and suburbs can get the care they need without having to travel too far. In August, a report from the Office of Inspector General of the federal Department of Health and Human Services recommended that 80 percent of these facilities be decertified.
When he learned of the report, David Wahlberg, a health/medicine reporter for the Wisconsin State Journal, interviewed administrators at critical access hospitals in Wisconsin and found that the administrators believed closing these hospitals would have a detrimental effect on care for Medicare patients. Continue reading