Receiving medical services via telehealth was a requirement for some during the pandemic but has continued to grow in popularity since then.

In states such as Nebraska with large rural areas, telehealth can be especially important. Certain pandemic-era telehealth "flexibilities" allowed by the Centers for Medicare and Medicaid will expire at the end of this year, prompting a new report by the Bipartisan Policy Center.

The report, "Positioning Healthcare Policy to Ensure High-Quality, Cost-Effective Care," recommended Congress make some of the changes permanent or at least extend them.

Maya Sandalow, senior policy analyst at the center, stressed the need for more research on telehealth. She called existing research "promising" but said it shows the quality can really vary.

"By what a person is seeking telehealth for, what service a provider is offering, and also what type of telehealth a provided," Sandalow outlined. "Is it a video where the patient and provider can see each other, or is it a visit over the telephone?"

The report supported allowing patients to continue to choose the location for their telehealth visits and allowing behavioral health services via telehealth without an in-person visit first, assuming the provider has a plan for patients in a crisis. Nebraska law has required both from Medicaid and state-regulated insurance companies since 2021, and payment parity -- paying the same rate for telehealth as for an in-person visit -- since 2023. However, only the Centers for Medicare and Medicaid Services can establish the guidelines for Medicare.

Sandalow acknowledged some believe payment parity is crucial to maintain access to services, whereas others fear it may "incentivize" providers to offer only telehealth services. But she stressed there is no doubt telehealth increases access to care, especially when it comes to behavioral and mental health services.

"It can be really high quality, equally good as compared to in-person care," Sandalow contended. "We're living in a behavioral health crisis, and any measures to expand access to care are really important."

Jed Hansen, executive director of the Nebraska Rural Health Association, said in addition to improving access, some find telehealth a more comfortable way to receive mental health services, especially in smaller communities.

"It just helps create that additional privacy by being able to stay in your own home or even close the door in your office and take that meeting," Hansen explained. "As opposed to having to drive and park your vehicle in front of a mental-health place."

Sandalow emphasized the need for the Centers for Medicare and Medicaid Services to find a way to assess the quality and costs of fully virtual providers and telehealth companies in particular.

On a related note, Hansen stressed the need to ensure telehealth regulation does not make it easier for out-of-state providers to interfere with the ability of Nebraskans to maintain a relationship with their local provider.

"What we don't want to have happen are these sweeping telehealth bills, and then to have an Amazon or a Walmart, or someone on the West Coast, that may not be providing an apples-to-apples service, and they'll come in and undercut the local health care system," Hansen cautioned.

People who are part of the Deferred Action for Childhood Arrivals program, known as DACA, will be dropped from their CoveredCA health plans at the end of August.

The move comes after the Trump administration changed a Biden-era definition of "lawfully present" to revoke health care eligibility for thousands of immigrants.

Christine Smith, policy and legislative advocate for the nonprofit Health Access California, said people only have a few weeks to get medical appointments in before their coverage ends.

"If you're enrolled in Covered California and you're a DACA recipient, the Trump administration just ended your coverage," Smith emphasized. "People should use as much of your health care as you can before the August 31st deadline."

The Centers for Medicare and Medicaid Services defended the move, saying it will save taxpayers money. CoveredCA estimated the change affects about 2,400 DACA recipients in the state who make too much to qualify for Medi-Cal and have jobs not providing health insurance. They can still buy private insurance but it is much more expensive. People who prepaid for their coverage can seek a refund.

Smith predicted it will be a blow not just to those who lose coverage but to the state's health care system as a whole.

"The lines in the ERs are going to be longer because people are not going to be able to get affordable preventive care," Smith projected. "They're just going to get sicker and then end up in the ERs. People will overall incur more medical debt. Hospitals will have more uncompensated care."

The change is nationwide. As of mid-July, about 538,000 people in the DACA program across the U.S. are ineligible to enroll in any state-based insurance marketplace and are unable to access premium subsidies or cost-sharing assistance.

Artificial intelligence is appearing more prominently in many aspects of life and research suggests older populations are curious, yet remain wary of using the technology in their everyday lives.

According to Stats Indiana, there are more than 1.5 million Hoosiers aged 65 and older, or 18% of the state's population. Experts said it is likely the demographic will use AI in some form in the next few years, either by choice or necessity.

Dr. Shaun Grannis, vice president of data and analytics for the Regenstrief Institute on Aging, said AI offers real benefits.

"It can reduce loneliness through conversation, provide reminders for medications and appointments," Grannis outlined. "It can support cognitive stimulation via games, storytelling, news updates."

The technology can also offer a low-pressure way to access information on public services, he added, which is valuable for those with mobility issues or those who feel intimidated by technology.

Grannis cautioned any tool which can be used for good can also lead to problems. He noted AI can create a false sense of companionship and mask social isolation. Overdependence is a legitimate concern, he argued, if the technology becomes a "crutch" for all forms of interaction.

"All cognitive activities or decision-making, it can actually lead to and create a negative feedback loop, lead to a decline in engagement and even basic self-management skills," Grannis explained. "This is risky."

Grannis believes one solution is designing AI systems to complement, not replace, human interaction. He stressed it can be done though building broader support ecosystems including family, friends, caregivers and community services. Grannis emphasized it would encourage real-world activity, prompting the user to go for a walk, call a grandchild or attend a local senior event.

If you have an extra five minutes, you can save a life because you can learn cardiopulmonary resuscitation at no cost from a new mobile, hands-only CPR kiosk.

The new kiosk is in the lobby of Saint John's Health Center in Santa Monica. The machine's touch screen gives a brief overview of hands-only CPR and you can practice right there, on a mannequin.

Dr. Rigved Tadwalkar, cardiologist at St. John's, said it is an easy way for people to get more comfortable giving chest compressions in an emergency.

"It's a lot like a video game but of course, a lot more important than a video game," Tadwalkar pointed out. "It gives real-time feedback about the depth and rate of compressions, proper hand placement, which are all factors that influence the effectiveness of CPR."

The American Heart Association operates the St. John's mobile kiosk and a stationary model at L-A-X with support from the hospital. Santiago Canyon College in Orange County also has a mobile hands-only C-P-R kiosk now through September, sponsored by Edwards Lifesciences.

Steven Munatones, an Orange County business owner, said he survived what's known as a "widowmaker" heart attack which led to cardiac arrest nine years ago, thanks to his 17-year-old son, who gave him immediate CPR with instructions from a 911 operator.

"You don't have to put your mouth to anybody's mouth," Munatones explained. "You just put your hand on their chest and pump. He saved me, and others can do the same, anywhere. So, it's absolutely a lifesaving, heroic act that anybody can do."

Statistics show 350,000 Americans suffer from cardiac arrest outside a hospital each year and about 90% die, in part because they do not receive CPR. About 70% of those cardiac arrests happen at home, so people often depend on family or friends to give CPR before an ambulance arrives.