Rural Matters

Michelle chats with Brian Doerr, Senior Vice President of Information Technology and Security, and Privacy Officer for Community Hospital Corporation of Plano, Texas; Carrie Zbierski, Chief Nursing Officer at North Texas Medical Center; and Andra Smith, Director of Practice Management at North Texas Medical Center about the evolving telemedicine presence in rural America and its capability to deliver specialty health services. Before the pandemic, Doerr notes, rural areas accesses telemedicine in a limited way, due to regulatory and reimbursement restrictions and lack of flexibility. But those barriers are being relaxed now, says Doerr. For example, he explains, remote telehealth visits by rural hospitals can be reimbursed by CMS or other payors, including commercial payors, who are moving cautiously in this area. Doeer expects continuing growth in this area, even after COVID-19, Zbierski says that more hospitals are interested in the use of telemedicine access specialty care providers, such as cardiologists and pulmonologists, to treat patients without them having to come into hospitals. Smith notes that because patients within her clinics are now learning how to use this new technology, their care management can becomes more than just annual visits. This episode is a must-listen for anyone interested in the challenges and opportunities of telehealth and its incredibly dramatic use in rural areas. This episode is sponsored by CHCH, www.communityhospitalcorp.com.

In this sixth and final installment of our excellent series, Living in Rural America —2022 and Beyond, produced in collaboration with and supported by the Robert Wood Johnson Foundation, Michelle discusses the future of rural with three outstanding guests: Dee Davis, Founder and President of the Center for Rural Strategies; David Lipsetz, President and CEO of the Housing Assistance Council (HAC); and Valerie Lefler. Founder and Executive Director of Feonix — Mobility Rising.

Davis discusses the best options for small towns facing economic challenges, the political divide between urban and rural communities and its effect on democratic institutions, and the impact of divergent media in the rural space. Lipsetz talks about the impact of housing issues on health, wealth, and education in rural communities, and how his organization is helping rural communities take advantage of opportunities in this space. Lefler discusses transportation barriers faced by rural communities, the connection between rural healthcare and mobility challenges, and how Feonix is working to provide solutions in these areas. This episode and the entire six-part series is sponsored by the Robert Wood Johnson Foundation., the nation’s largest philanthropy dedicated solely to health. For more information on RWJF, visit rwjf.org or on Twitter @rwjf.

In this second in our four-part series, Rural Communities: Conquering Challenges, Optimizing Opportunities, in partnership with and supported by the Robert Wood Johnson Foundation, Michelle chats with Nancy Dickey and David Lipsetz.  Dickey spent almost a dozen years as president of the Texas A&M Health Science Center and vice chancellor for health affairs for The Texas A&M University System and currently serves in several academic and administrative roles at the College of Medicine and as executive director of the Rural and Community Health Institute. She also is part of the leadership team at the Center for Optimizing Rural Health, which was created last year with funding provided through the Vulnerable Rural Hospitals Assistance Program. Lipsetz is Chief Executive Officer at the Housing Assistance Council, a national nonprofit that has been helping rural America address poverty and hardship since 1971. Less than 7 percent of the philanthropic work conducted in the United States is done in rural America, notes Lipsetz, and less than 6 percent of mortgage deductions were filed by residents in rural communities. Lipsetz invites listeners to get in touch with his organization to talk about how to link the potential capacity of high-quality housing in rural and small towns offered by his organization with recruitment of providers that needs to be done by hospitals. Dickey notes that, in certain communities, hospitals have become “landlords” for intermediate housing because they’re forced to, in order to attract providers. In addition, Dickey says, sometimes hospitals arrange for apartment sharing among providers and also to provide tertiary care through telehealth services. Lipsetz notes that poverty clearly is a social determinant for quality of care since it limits access for rural patients, leading to unacceptable infant mortality and increased morbidity rates. This episode was sponsored by the Robert Wood Johnson Foundation, www.rwjf.org and Thomas USAF, which on December 4 is sponsoring the 20th Annual National Rural Lenders Roundtable in Washington, D.C, www.nrlrt.com.

Michelle chats with Katrina Badger, program officer with the Robert Wood Johnson Foundation, about the work of the foundation to build a culture of health and her particular focus on creating the community conditions that foster improved health. Badger discusses a poll that was released at the recent Life in Rural America symposium, which was a collaboration among the Foundation, NPR, and Harvard, that focused on rural issues. Just organizing the event was a learning experience, Badger notes. One of the takeaways of the symposium, she says, was that Rural America is not a monolithic space but a diverse one. Many rural communities have won the Culture of Health prize, Badger points out. Another key point: Economic opportunity is critical for success for rural residents and communities. Yet another insight: Innovation knows no area code. Badger notes that a key question that must be asked is how can we build power for rural communities to implement what are known to be successful policies. And a final takeaway: Equity conversation, whether racial or economic or some other kind of equity, is equally critical in the rural context. This episode was sponsored by For the Win Robotics, www.ftw-robotics.com; REC Foundation, www.roboticseducation.org;  and the Rural Assembly, https://ruralassembly.org

For more on the Robert Wood Johnson Foundation symposium, visit www.rwjf.org/ruralhealth

Michelle chats with two very important advocates in the rural space: Whitney Kimball Coe, coordinator of the National Rural Assembly, a rural movement comprised of activities and partnerships geared toward building better policy and more opportunity across the country; (the Rural Assembly is part of Rural Strategies, which also includes Daily Yonder, a definite go-to read for anyone interested in rural matters); and Edyael Del Carmen Casaperalta, Fellow at the American Indian Law Program at the University of Colorado Law School in Boulder, where she researches and writes about federal Indian law, international human rights, indigenous peoples’ rights, and telecommunications and technology. Coe has established a focus on building civic courage in communities and is directly tied to a practice of participation in her hometown of Athens, TN. Del Carmen Casaperalta is a budding attorney dedicated to serving indigenous peoples and poor communities in telecommunications and technology law matters. The National Rural Assembly is holding its first Rural Women’s Summit Oct. 28-29 in Greenville SC. The Summit will begin with a panel comprising women journalists and will include sessions covering running for public office, curating your own story, gender, identity, and power. Rural Matters will be recording a podcast live from the Summit, #ruralwomenlead. For more information, visit ruralassembly.org. This episode was sponsored by Bryan Telemedicine, https://www.bryanhealth.com/services/telemedicine/; Phynd, www.phynd.com; REC Foundation, roboticseducation.org; For the Win Robotics, frw-robotic.com; and the Rural Assembly, ruralassembly.org.