Q&A: What is needed to reform the ‘massively broken’ rural healthcare system?

Accessing and delivering healthcare in rural areas is a challenge for rural American Americans They face health inequalities compared to their urban partners and have to travel more to get to the hospital. Meanwhile, hundreds of rural hospitals are at risk of closing, and nineteen of the COVID-19 epidemics in 2020 have closed their doors.

Earlier this year, Chronic Care Management Company CEO Dr. with other veterans. Jennifer Snyder Livango has launched Homeword, which aims to provide care in the rural market through a combination of virtual and personal care provided through mobile units. The startup recently announced its first partnership with WrightAid, allowing pharmacists to connect to the homeword to care for their Medicare-eligible customers.

Sat down with Snyder MobiHealthNews To discuss collaboration, how their model works and why value-based care is best for rural communities.

MHN: What made you decide to tackle rural healthcare for your latest initiative?

Dr. Jennifer Snyder: I think it’s a combination of a few things. One is when you look at how broken rural healthcare is. It’s not a little broken. It is massively broken. It’s in a crisis. And so it is a big problem, and about 20% of all Americans live in rural markets.

Secondly, it is very personal to me. So I grew up in rural Minnesota, and, as I began to read more about the problems and think about my own personal journey and my family’s journey, it became increasingly important, out of personal motivation and “because of a big hard work.” . Problems “Inspiration.

MHN: So there are some startups who are focusing on this hybrid model of virtual combined with personal care. How did you make that distinction for rural areas?

Snyder: There are many people in the healthcare ecosystem today who are combo / hybrid. But I think as you design, you have to design for the end users. And so the specificity surrounding the rural market is deeply understood that it has broken down for the people.

So if you look at the rural market, there is no infrastructure like the urban market. They do not have public transport. They have no broadband connection, or no limited broadband connection So the design of the solution has to be adapted to the infrastructure of the rural market. In urban markets, ‘Oh, you can see a doctor from time to time and make a virtual visit,’ adopting a hybrid does not actually answer the existing problems in the rural market.

We spend a lot of time obsessed with the end user or patient and really try to understand why it broke from their lens and what we can do to fix it. The announcement of our partnership with Right Aid is a great example of this.

Access a Big problem. When you need to see a doctor, you need to drive more than one hour for a 15 minute visit. If you are an hourly wage worker, it is not an unreasonable decision to do so. You’re giving up a full day’s pay for a 15-minute visit.

So partnering with Rite Aid is a great example of staying in one place, our provider’s convenience is parking where people are in their daily stream, where they go to get their prescription, where they go to buy some groceries, wherever they go. To meet with band-aid because they are coaching the football team.

It’s really about deeply understanding what people need and reversing the care delivery system to deliver it, ‘We’re going to build a centralized hospital, and you can all come here.’ Because that model was not profitable in the rural market.

MHN: Was it a deliberate choice to pick a pharmacy as your first partner?

Snyder: Yes, that was the intention. So when you look at healthcare touchpoints, pharmacies have the most touchpoints, between 20 and 30 per year. Very few of us see or talk to our doctor or care team many times a year.

The second is that the local pharmacist is a really trusted entity in any market, especially in the rural market. I live in a rural market in Napa Valley right now, and I have Jeff Smith’s cell phone number plugged into my cell phone so I can call them off hours when something comes up. It is a combination of both healthcare access and trust. That’s why we started with pharmacy.

MHN: So one of your big points is moving away from fee-for-service payments. What do you think is particularly important for the rural community? Or does it reflect how healthcare in general should change?

Snyder: I think it is best to provide sustainable healthcare in the rural market. I also think that this is a reflection of some movement in the healthcare ecosystem.

The reason I say this is that if you think about the type of care needed to deliver lasting results, things like remote patient monitoring will be needed. How can you evaluate and provide information, or receive information for care, in a world where access is the number one problem?

A lot of virtual care, if you build a business that integrates these elements into a fee-for-service world, the economy is not sustainable. In order to actually use the care you need to be sustainable and successful in providing care, I think total capitalization in rural markets is really the only way.

Also, as you mentioned, there is a change in healthcare to allow people who can pull the liver, if you want to, and to retain some of those risks or to own some of those risks. But it’s best in rural areas, I don’t think it’s the most in urban areas.

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