Rural America has fewer primary care providers, smaller hospitals, and citizens with higher rates of disability and chronic conditions. Telehealth offers an opportunity to reach rural individuals with the care they need, but there are challenges to be overcome for telehealth to be a solution to health care disparity for rural Americans.
Rural America Needs Access
The biggest, most obvious challenge for rural telehealth is the lack of access to reliable broadband Internet technology. According to the Federal Communications Commission, more than 18 million Americans lack access to high-speed Internet. In rural areas specifically, nearly 1 in 4 people cannot get reliable broadband.
Cost is another prohibiting factor. Rural communities are typically poorer than urban and suburban areas, making affordability a barrier to Internet access. Add to that, the US has the third most expensive Internet in the developed world.
There is even a challenge to connecting with members via cellular service. In some areas, service can be spotty. Plus, some members do not own a smartphone. According to the Pew Research Center, 71% of rural residents own a smartphone compared to 83% for both urban and suburban residents.
Engagement and Education for Rural Members is an Ongoing Effort
Connectivity challenges aside, plans and providers are challenged to educate rural members about telehealth.
- Plans need to prioritize maintaining accurate member contact information so member outreach can make a connection.
- It is important to identify members who would most benefit from telehealth to educate them about the services.
An obvious engagement opportunity exists for members with disabilities that prevent them from traveling to see a provider or those with chronic health conditions who would benefit from consistent monitoring and education.
The Promise of the Rural Health Initiative
In September, The Department of Health and Human Services released the Rural Action Plan. The plan’s intent is to enhance the way health care and human services are delivered to rural areas, focusing on four areas:
• Build a Sustainable Health Model for Rural Communities
• Leverage Technology and Innovation
• Focus on Preventing Disease and Mortality
• Increase Rural Access to Care
The stated goal for the Rural Action Plan is to ensure services are affordable, accessible, high quality, sustainable, and innovative.
Whether the initiative delivers on its promise remains to be seen, but if the intent is achieved, rural members could participate in the growing availability of telehealth to improve their care.
What Can Plans Do Right Now?
- Engage Member Services – Plans can consider educating their member service representatives on rural health disparities and challenge them to engage members to make a difference. Can representatives ask members about their access to Internet and phone? Can plans track who does and does not have access? Are there resource referrals that can help rural members who do not have access?
- Reach Out – As rural areas grapple with COVID-19, it makes sense to reach out to the most vulnerable. Does the member have a primary care provider? Have they kept up with preventive care appointments (including flu shots)? If they have a chronic condition, are they maintaining their care?
- Engage Government Relations – What role do plans have in advocating for their members? It is a good time for plans to consider simply sharing the stories of members with legislators. Help make the voice of rural members heard so they can get the health care they need.