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Rural Dispatch: April 2024

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Monday, Apr 29 2024

Some Medicaid Providers Borrow or Go Into Debt Amid ‘Unwinding’ Payment Disruptions

Katheryn Houghton

Used to operating with scarce resources, Montana Medicaid providers say gaps in state payments have left them struggling further.

A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?

Molly Castle Work

There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.

After Appalachian Hospitals Merged Into a Monopoly, Their ERs Slowed to a Crawl

Brett Kelman and Samantha Liss

Ballad Health was granted the nation’s largest state-sanctioned hospital monopoly in 2018. Since then, its emergency rooms have become more than three times as slow.

Exposed to Agent Orange at US Bases, Veterans Face Cancer Without VA Compensation

Hannah Norman and Patricia Kime

The Department of Veterans Affairs has long given vets who served in Vietnam disability compensation for illness connected to Agent Orange harm. But those exposed at U.S. bases are still waiting for the same benefits.

Mandatory Reporting Laws Meant To Protect Children Get Another Look

Kristin Jones

The state is looking at ways to weed out false reporting of child abuse and neglect as the number of reports reaches a record high.

Tire Toxicity Faces Fresh Scrutiny After Salmon Die-Offs

Jim Robbins

Tires emit huge volumes of particles and chemicals as they roll along the highway, and researchers are only beginning to understand the threat. One byproduct of tire use, 6PPD-q, is in regulators’ crosshairs after it was found to be killing fish.

Unsheltered People Are Losing Medicaid in Redetermination Mix-Ups

Aaron Bolton, MTPR

Some of the nearly 130,000 Montanans who have lost Medicaid coverage as the state reevaluates eligibility are homeless. That’s in part because Montana kicked more than 80,000 people off the program for technical reasons rather than income ineligibility. For unhoused people who were disenrolled, getting back on Medicaid can be extraordinarily difficult.

Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don’t Meet Them.

Jordan Rau

The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesn’t go far enough. Labor unions welcomed the requirement.

Rural Jails Turn to Community Health Workers To Help the Newly Released Succeed

Lillian Mongeau Hughes

To reduce recidivism, some rural counties are hiring community health workers or peer support specialists to connect people leaving custody to mental health resources, substance use treatment, medical services, and jobs.

Native Americans Have Shorter Life Spans. Better Health Care Isn’t the Only Answer.

Arielle Zionts

Social services, such as parenting classes and economic development programs, can help increase the life spans of Native Americans, some health experts say. But insurers don’t always cover these services.

Swap Funds or Add Services? Use of Opioid Settlement Cash Sparks Strong Disagreements

Aneri Pattani

The national opioid settlements don’t prohibit using money for initiatives already supported by other means, but doing so could dilute the impact.

After Uphill Battle, Company Is Poised for Takeover of Bankrupt California Hospital

Melissa Montalvo, The Fresno Bee and Bernard J. Wolfson

American Advanced Management, a steadily growing operator of small hospitals, is expected to get the green light from a bankruptcy court next week to take over the shuttered Madera Community Hospital. Some community groups worry about the company’s track record.

Arkansas Led the Nation in Measuring Obesity in Kids. Did It Help?

Kavitha Cardoza

For more than 20 years, children in Arkansas have been measured in school as part of a statewide effort to reduce childhood obesity. But the letters have had no impact on weight loss — and obesity rates have risen. Still, the practice of sending letters has spread to other states.

Doctors Take On Dental Duties to Reach Low-Income and Uninsured Patients

Kate Ruder

More doctors are integrating oral health care into their practices, filling a need in America’s dental deserts.

Congress Likely to Kick the Can on Covid-Era Telehealth Policies

Sarah Jane Tribble

With an end-of-year deadline and a presidential election approaching, payment rules that fueled rapid expansion of telehealth in the United States face a last-minute congressional decision.

City-Country Mortality Gap Widens Amid Persistent Holes in Rural Health Care Access

Jazmin Orozco Rodriguez

People in their prime working years living in rural America are 43% more likely to die of natural causes, like diseases, than their urban counterparts, a disparity that grew rapidly in recent decades, according to a new federal report.

End of Internet Subsidies for Low-Income Households Threatens Telehealth Access

Sarah Jane Tribble

A federal program that helped pay for more than 23 million low-income households’ internet access runs out of money soon. The end of the subsidy launched earlier in the pandemic could have profound impacts on health care access.

For-Profit Companies Open Psychiatric Hospitals in Areas Clamoring for Care

Tony Leys

State institutions and community hospitals have closed inpatient mental health units, often citing staffing and financial challenges. Now, for-profit companies are opening psychiatric hospitals to fill the void.

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