High Plains Journal reports on a recent webinar on rural telehealth…
A July 15 webinar on those issues was hosted by Kevin Oliver, lead relationship manager at CoBank, part of the Farm Credit System that supports key initiatives in both rural broadband and healthcare. Titled “COVID-19 Impacts On Rural Healthcare and Broadband,” it is the fourth in the “From the Farmgate” series of webinars sponsored by CoBank. The speakers were Rick Breuer, CEO of Community Memorial Hospital, located in a rural area of Minnesota just west of Duluth; and Catherine Moyer, CEO of Pioneer Communications, which provides connectivity services in western Kansas via coaxial cable, copper wire, fiber and wireless.
I was especially interested in the bottom line impact to the broadband providers versus the healthcare facilities (the tele vs the health)…
Oliver noted that the cost dynamic was different for health care facilities and communications. Health care facilities saw a simultaneous increase in costs and decreases in revenue. On the other hand, communications companies have added customers and grown more quickly than they might have otherwise. While some payments are in arrears, “most of those arrears will be collectible,” said Moyer—whether from customers, or by laws like the Critical Connections Act that reimburses communications companies. Moyer said Pioneer had “donated” about $500,000 worth of connection services that may or may not be reimbursed.
Breuer said he doesn’t expect revenues at the hospital to return to anything like their full levels for at least a year. The hospital has managed to avoid layoffs or furloughs, “but we’re getting [through] by the skin of our teeth.” Whatever happens with COVID, he said, “telehealth will definitely be part of our future. Home and hospital connections are equally important, since telehealth often happens from home.”
Breuer noted that until recently, he had to drive his kids into town to access hot spots so they could do their homework. One hospital sectioned off part of its parking lot for customer parking to use its hot spot, whether for medical tele-visits or other reasons. He also noted the vulnerability of rural networks, with little or no redundancy. He said one gnawing squirrel recently took down connectivity for a 50-square-mile area.
His hospital could not have kept its doors open without help from 10 separate funding organizations, said Breuer—but that in turn created a lot of documentation paperwork. He said independent clinics have been the worst-hit by the COVID crisis, especially those that service mostly rural populations but that don’t technically qualify as rural health clinics for one reason or another. Breuer supports changing those designations to allow more clinics to be helped.
Moyer supports what she calls contribution reform. Bill surcharges are based on an outdated model of long-distance service, now that texting has taken the place of phone calls for many. Fortunately, “the COVID crisis has focused the attention of many in Congress. I’ve been talking about all these connectivity issues for 20 years,” she said. “The silver lining is a lot of other people are focused on this issue now too.”
For so many years, the providers have invested (often with public support) in the networks that have made millions for private industry without reaping the same benefit. (A couple years ago, I looked at the community ROI of public investment in rural broadband – the community sees the return much more quickly than the provider.) It will be interesting to see what happens with healthcare and telecom/broadband. Many broadband providers are being generous with free/low cost connection right now and hopefully that will be an investment in a future paying customer. While the hospitals are in a different situation – the article points out that “163 rural hospitals have closed and about 600 more are vulnerable, or a third of all rural hospitals in the United States.“