In the past two years, conversations about access to care have intensified, especially for expecting parents. Amid a national shortage of OB-GYNs, hospital closures, the consequences of the COVID-19 pandemic, and the passage of bills like Texas’ SB8, access to quality maternity care is at risk. In rural communities, the effects are more concentrated: families must travel farther for care, and the lack of prenatal and perinatal specialist care leads to worse health outcomes for mothers and children.
However, the expansion of telehealth and virtual care services is helping rural communities fight back, empowering parents to take control of their health in convenient, affordable ways.
The rural healthcare delivery dilemma
There are a number of challenges facing healthcare delivery in rural communities. With lower population densities than urban centers, and lower median incomes, rural areas often have smaller tax bases to fund quality services and facilities, including quality specialty care for family building. Inclusive family building services for single parents and LGBTQIA+ couples are scarce.
Since 2005, over 181 hospitals in rural communities have closed — resulting in a worsening shortage of doctors per capita.. According to the National Rural Health Association, “the patient-to-primary care physician ratio in rural areas is only 40 physicians per 100,000 people, compared to 53 physicians per 100,000 in urban areas.” Similarly, half of U.S. counties lack a single OB-GYN.
For families, there are fewer healthcare services available overall, and those that are available are often of lower quality than those provided in urban centers. Consequently, rural residents typically travel about twice as far to hospitals as their urban counterparts. For mothers, this translates to higher infant and maternal mortality rates. A 2015 study found that “rural black women have a 30% higher maternal mortality rate than urban black women, and rural white women have a 50% higher risk of maternal mortality than urban white women.” Because rural communities have fewer facilities and providers, and less ability to afford services that are increasing in price year over year, many families are simply not receiving or seeking necessary care.
Policymakers, legislators, and innovators have taken a keen interest in alleviating these structural disparities and inequities. Many are turning to telehealth and virtual care to solve these geographical challenges, providing a digital conduit through which women and families can access affordable, high-quality care.
Telehealth tangibly improves outcomes for rural families
Telehealth exploded in popularity and usage during the early days of the COVID-19 pandemic, when access to care was severely limited by overfilled hospitals and restrictive nationwide lockdowns. Over time, however, the benefits of telehealth have become apparent beyond the context of a global pandemic. In rural areas, expecting parents could access primary and specialty care without having to leave their homes, with appointment times that worked with their schedules. Telehealth could address access to care challenges that existed well before the pandemic, and were only exacerbated by it.
As such, rural healthcare centers have adapted quickly to the advent of telehealth, with a positive impact on health outcomes. A recent study of moms receiving telehealth antenatal care in rural Arkansas found that it reduced the need for in-person visits for mothers by over 50% while still maintaining the “appropriate utilization of maternal–fetal medicine subspecialty consultations.” Another study found that telemedicine-based interventions for high-risk pregnancies reduced very low birth weight deliveries from 13 to 7%, and statewide mortality rates decreased from 8.5 to 8%.
Researchers, providers, and legislators have concluded that telehealth can tangibly improve birth outcomes in rural communities, but questions remain about telehealth access, quality of care, and sustainability.
Sustainable perinatal telehealth solutions
There are several critiques of telehealth care models and delivery. From reimbursement and cost structures, to user experience and the human aspect of care, questions abound among providers and patients as to whether telehealth can serve as a sustainable solution to the multitude of barriers to care.
Healthcare doesn’t exist in a vacuum: deficiencies in the broadband internet infrastructure affect rural communities, and skew across racial and social lines. Poorer families, and especially families of color, are less likely to have consistent internet access in rural areas. Virtual consultations rely on high fidelity, low-latency video calls for a positive user experience.
Providers adjusting to telemedicine must learn how to establish emotional connections and trust in a virtual space. Ben Kaplan wrote in the Annals of Family Medicine, “In an in-person visit, the patient enters a physical space which is clearly demarcated as mine, not theirs: a “doctor’s office….while telehealth certainly does not eliminate all of these complex dynamics, it presents an opportunity to connect with each patient in a new context.”
Building sustainable telehealth models and solutions requires empathy, accessibility, and humility. For rural families, and especially those in marginalized communities, telehealth can eliminate some of the barriers and power dynamics that are present during in-person visits. It can expand the breadth of providers they can see, and open up doors to specialty care they otherwise would have to travel hours and potentially wait months to see. Thus, it’s theorized and recommended that a hybrid model—one that combines telehealth consultations and in-person visits—can drastically improve outcomes for these communities.
The Maven approach to family telemedicine
Maven’s innovative care model provides high-quality, culturally humble, care that’s available anytime, anywhere. Members have 24/7 access to a worldwide network of providers covering over 30 different family health specialties, and over 250 different subspecialties spanning family planning to parenting and pediatrics.
For rural families, that means access to fertility awareness educators, reproductive endocrinologists, lactation consultants, sleep specialists, mental health providers, career coaches, and others whom they might otherwise never be able to see. For LGBTQIA+ families and individuals, they can access care from providers who understand and empathize with their circumstances and can provide steerage to affiliated clinics and agencies that they might not otherwise have access to.
What makes Maven unique is its emphasis on high-quality care for every member. Dedicated Care Advocates help guide members through their journey, and can provide referrals to high-quality virtual and in-person care that’s covered by their insurance. Members can use the platform to seek advice, get their questions answered, and receive care rapidly, in between in-person appointments.
Employers with distributed workforces now have to contend with the fact that having good insurance isn’t enough: when access to care is restricted, whether by geography, a pandemic, or institutional inequities, their employees suffer. Telehealth solutions, like Maven, can bridge those gaps in care for their most vulnerable populations, regardless of where they live. For Health Plans looking to provide a telemedicine solution that will delight their members and drive critical maternal and family health outcomes, Maven provides an unparalleled user experience with proven clinical success.
To find out how Maven can help your employees, members, or patients receive the care they need, request a demo today.
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