Telehealth and Rural Student Support: What's Working, What's Not

Telehealth was supposed to solve the rural access problem. It's helped — but the picture is more complicated than the headlines suggest.

When telehealth expanded rapidly during the pandemic, there was real optimism that it would finally solve the rural access problem. And it has helped — significantly. But the picture is more complicated than the headlines suggest, and rural communities shouldn't assume that telehealth alone is the answer.

The access gains are real. Families who previously had to drive 60 or 90 minutes to see a provider can now access care from home. Providers who weren't willing to relocate to rural areas can now serve rural patients. Waitlists have shortened in some areas as the pool of available providers has expanded.

But the barriers are also real. Reliable broadband is still not universal in rural Missouri. A telehealth appointment requires a private space — something that's not always available in crowded homes or for students trying to access services from school. And for some people, particularly older adults, the in-person relationship with a provider matters in ways that a screen can't replicate.

There's also a reimbursement question. Telehealth parity laws — which require insurers to reimburse telehealth at the same rate as in-person care — have improved, but they're not universal, and the regulatory landscape continues to shift.

My view is that telehealth is a valuable tool that should be part of every rural community's strategy — but it's not a substitute for building local capacity. Communities still need local providers, local coalitions, and local systems. Telehealth extends reach; it doesn't replace roots.