The latest episode of Bridging the Gap features Ryan Kruis, Director of Research and Grants at the Medical University of South Carolina (MUSC). In this conversation with NeuroFlow CEO Chris Molaro, Ryan discusses how MUSC leverages telehealth to extend specialty care access across South Carolina, particularly focusing on rural communities that face significant healthcare challenges. The discussion, held during the second annual NeuroFlow Summit, explores innovative approaches to healthcare delivery, grant funding strategies, and the evolution of behavioral health integration. Tune in or watch the episode below!
On the critical healthcare challenges facing rural communities in South Carolina:
Ryan: Down the I-95 corridor, it’s got some of the worst outcomes in the country, worse than some developing countries. We have counties that don’t have practicing pediatricians, so that’s where our school-based telehealth program becomes really critical, trying to meet kids where they are. We have apps and pediatricians that beam into carts in the schools. That’s one of the innovative places that we are layering on some of the behavioral health initiatives.
South Carolina is also considered part of the Stroke Belt because it has such high rates of strokes.
Chris: Is there a reason for that? I’ve never heard of the stroke belt.
Ryan: You’ve got these historic social determinants of health, systemic racism, and other things that have influenced some of the dynamics in the area. But then also one of the emerging issues that we’re seeing a lot is just funding for rural healthcare generally. A lot of primary care offices have a very difficult time making ends meet, and then rural hospitals are closing, or a lot of times because different specialties aren’t available, rural hospitals get bypassed. And so it makes it really hard. . . So figuring out innovative ways using telehealth and unique ways of partnership to keep care local, but augment that via telehealth has really been critical for us.
On MUSC’s innovative approach to expanding specialty care access:
Ryan: One of the really innovative things we’ve developed in the last couple of years. . . is virtual-first practices. So we actually have rheumatologists and endocrinologists and more. We’re continually onboarding new specialties. We’ve got the oncologist and others that are virtual-only practices. So we’ve got a team of nurses that helps coordinate local labs, coordinate local imaging if that needs to happen. But all of the visits occur virtually. And so this has really helped us make a dent in some of our wait times for these specialists.
And we’re using it strategically to try to tackle some health equity issues too. There’s a large burden of sickle cell in some of these areas and along that corridor I mentioned. And so bringing on a hematology oncology provider that can see patients virtually in their homes has really reduced a lot of the wait times and increased access for this really high needs and population that faces a lot of other health equity issues
On driving sustainability for grant-funded programs:
Ryan: Sustainability is always top of mind when we do any of these grant innovations. So a big piece of it is making sure we are collecting good outcomes data from the outset, so that we are demonstrating that this innovation can work. We can bring that to our payers and maybe do some direct negotiation or use that to advocate for payment. One of the things I’m really excited about. . . is collaborative care. We are very excited that South Carolina Medicaid is getting ready to turn on the collaborative care codes. . . Medicare reimburses CoCM, our private payers reimburse CoCM, but Medicaid has not. And that has been a huge barrier for the adoption of CoCM in South Carolina. But as of October, those are turned on and a lot of that is a result of advocacy and data that we were able to share that was generated from grants.
Show Notes
- To learn more about MUSC’s telehealth initiatives and technical assistance programs, visit telehealthcoe.org.
- Learn more about South Carolina Medicaid reimbursement for collaborative care codes.
