内容摘要：To reach the house, visitors drive up the dark, narrow mountain road hemmed in on both sides by foliage, before arriving, slightly carsick, slightly confused, at the low-slung residence with a modest roofline.

To reach the house, visitors drive up the dark, narrow mountain road hemmed in on both sides by foliage, before arriving, slightly carsick, slightly confused, at the low-slung residence with a modest roofline.

“If the hospital didn’t exist, there wouldn’t be any physicians there,” Miller said. “There is no place to go and get a lab test except for that hospital. There may be no nursing home or place to get rehab or long-term care other than these hospitals.”When a hospital does stay open in a large rural area where few people live, the facility may not see the number of patients it would need to see to be profitable, said Arrianna Planey, who researches health policy and management at the University of North Carolina.

Leaders in Brownsville tried to find a buyer for the hospital. The county eventually purchased it. Braden Health, a privately held company, then took over the hospital with two conditions from the county supervisors: It must be a full-service hospital with a 24-hour emergency room and staff had to be hired as quickly as possible. Local officials say the hospital is breaking even.Tennessee is one of 10 states — many of them in the South — that haven’t expanded Medicaid. Michael Meit, the director of East Tennessee State University’s Center for Rural Health Research, believes doing so would be an obvious solution to the problem of growing rural health disparities. More people would be covered by insurance, Meit said, and hospitals could make more money.“They’re providing a lot of uncompensated care,” he said of rural health systems in those states.

Miller acknowledged that Medicaid expansion can help, but argued that pinning hopes on that alone has “let the private insurance plans off the hook.”“In some cases, the small hospitals are losing more money on private insurance than they are on Medicaid, which is really kind of remarkable,” he said, “but that’s how little they get paid ... by the private insurance plans.”

Low Medicaid reimbursements play a role in

, along with worker shortages and declining birth rates. More than half of rural hospitals have stopped offering labor and delivery services, another recent analysis from the Center for Healthcare Quality and Payment Reform showed. That can lead to longer travel times and aThen, of course, is the financial incentive: Longer albums equate to more streams, and streams often account for far more of an album’s chart position than downloads and purchases.

All that aside, everything Wallen does, including the release of this new album, is inextricable from his controversies. Despite them — or perhaps, partially because of, forinterested in bad boys with real talent — Wallen has become one of the biggest performers in the United States, underestimated by a mainstream music media that often regionalizes country music culture.

And there have been a number of controversies. In 2020, he was arrested on public intoxication and disorderly conduct charges after being kicked out ofbar in downtown Nashville. In 2021, after video surfaced of him