Tag Archives: rural

Rural health providers alarmed by regulatory changes #ahcj14

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

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

Mo. journalist reminds us that reform does little to improve actual delivery of care

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

“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.

Jim Doyle

Jim Doyle

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

Dental therapist tells of treating patients in remote Alaska

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

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

What really happens if hospitals lose ‘critical access’ status?

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

David Wahlberg

David Wahlberg

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

Rural areas pose challenges for insurance marketplaces

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

AHCJ webcastAn estimated 60 million Americans live in rural areas of the United States. How these Americans use the new insurance marketplaces could be the key to success (or failure) of the Affordable Care Act.

This is an issue our panelists will address on Thursday, Oct. 17, at 2 p.m. Eastern, when AHCJ hosts a webcast, “How will rural Americans tap into the insurance marketplaces?”

Each state is wrestling with issues related to enrollment in the health insurance marketplaces. For journalists in the 29 states that the federal government considers to be mostly rural, the issue of how many residents enroll will be particularly important to follow in the coming months.

Our panelists (Al Cross, director of the Institute for Rural Journalism and Community Issues at the University of Kentucky; Jim Doyle, who covers the business of health care for the St. Louis Post-Dispatch; and Alan Morgan, CEO of the National Rural Health Association) will address this issue among others during the one-hour webcast. Reporters will have plenty of time to ask questions of the panelists. Continue reading

Toolkit, scientists offer tips on covering oral health in rural communities

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Mobile dental clinic

Image by Michael Coghlan via flickr.

Want to know more about innovative dental care programs reaching rural areas? Curious about oral health disparities in isolated communities? Looking for rural health contacts, programs or statistics for your state?

You might want to check out a Rural Oral Health Toolkit just launched by the Rural Assistance Center, a rural health information portal established by the U.S. Department of Health and Human Services’ Rural Initiative.

The toolkit is primarily geared toward helping rural communities set up successful and sustainable oral health programs. But it might just as easily serve as a source of story ideas and background for journalists covering rural places.

On the site you can learn about initiatives such as the “Into the Mouths of Babes” program. It addresses the shortage of Medicaid dentists in rural North Carolina by training physicians to apply fluoride varnishes to the teeth of small children.

You also can find out more about mobile clinic programs that have been successfully bringing screenings, education and care to children in isolated communities from Louisiana to South Dakota. There are school-based, dental home, community outreach and workforce auxiliary models as well. Elsewhere on RAC’s site, you can locate directories for rural hospitals and federally qualified health centers and state-by-state listings for rural health care resources. Continue reading

Reclassification impacts access to health care for millions of rural older adults

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Telemedicine equipment

Photo by Kevin Souza via Flickr

Back in January, the FCC announced $400 million in funding for creating and expanding rural broadband networks to support telemedicine in medically underserved regions.

Their HealthCare Connect program links urban medical centers and rural clinics, providing real-time consults with immediate access to a patient’s electronic medical records. Since adults 65 and older comprise roughly 14.4 percent of rural residents, this would appear to be an ideal use of technology to contain costs, facilitate care and improve preventive services.

However, last month, the U.S. Office of Management and Budget reclassified Metropolitan Statistical area delineations and moving 97 counties from rural to metropolitan designation. That eliminates Medicare reimbursement for telemedicine services in those areas. Yet just the day before, these same seniors were eligible, avoiding long-distance travel for consults or even basic health check ups. Continue reading

Medical, support network lacking for returning National Guard, reservists

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

National Guardsmen and reservists returning from duty in Iraq and Afghanistan “have been hastily channeled through a post-deployment process that has been plagued with difficulties, including reliance on self-reporting to identify health problems,” according to an investigation by graduate students in Northwestern University’s Medill School.

nat-guard-iraq

Photo by The National Guard via Flickr

Hidden Surge” found members of the National Guard must navigate disparate health care and support providers, made more difficult by the fact that many of them live in rural areas. Three of the stories were published in The Washington Post.

The reporters also found that, in the immediate aftermath of 9/11, most reservists were medically unready to deploy – an assessment made by a private contractor. “More than 2,400 Army Reserve soldiers were held back, at least temporarily, because of inaccurate assessments by the contractor, according to data provided by the Army Reserve Medical Command.”

Meanwhile, some soldiers with behavioral problems that could be aggravated by the stress of deployment and combat were improperly sent overseas.

The project, done by 10 students, was directed by faculty member Josh Meyer, who covered national security for the Los Angeles Times for 20 years. Students used video and interactive graphics to help tell the stories. A “How We Did It” sidebar says the students interviewed more than 150 people, reviewed documents and reports and traveled to nine states to do the reporting.

According to a press release, the Hidden Surge project is part of Medill’s National Security Journalism Initiative, funded by the McCormick Foundation.

Doctor shortage a ‘crisis’ in Wash. (#ahcj09)

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Marc Ramirez of The Seattle Times writes about Health Journalism 2009, focusing on a panel about medically underserved areas.

He reports that Even as the population of older people and ethnic minorities continues to grow in those communities, the shortage is worsening as many current rural doctors reach retirement age and fewer available candidates emerge from U.S. medical schools.”

“It’s a crisis, there’s no question about it,” said Anita Monoian, chairwoman of the National Association of Community Health Centers.

Read Ramirez’ article.

Workshop speaker to lead national group

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Dennis Berens, director of the Nebraska Office of Rural Health, who helped kick off AHCJ’s first Rural Health Journalism Workshop a few months ago, has been elected next president of the National Rural Health Association.

Dennis Berens

Dennis Berens

He has been a ready source for AHCJ members working on rural health stories. Berens is also a member of the National Rural Health HIT Coalition and has served on the National EMS/Trauma Advisory Board for Health Resources and Services Administration.

Prior to his work in state government, Berens was co-publisher of the Seward County Independent newspaper in Nebraska.