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Rural Project Examples: Home health

Effective Examples

funded by the Federal Office of Rural Health Policy Perinatal Health Partners Southeast Georgia
Updated/reviewed February 2017
  • Need: In the 11 rural southeast Georgia counties, high-risk pregnant women potentially face adverse birth outcomes, including maternal or infant mortality, low birthweight, very low birthweight, or other medical or developmental problems.
  • Intervention: An in-home nursing case management program for high-risk pregnant women in order to maximize pregnancy outcomes for mothers and their newborns.
  • Results: Mothers carry their babies longer and the babies are larger when born, leading to improved health outcomes.

Promising Examples

funded by the Federal Office of Rural Health Policy Community Health Coaches for Successful Care Transitions
Updated/reviewed September 2017
  • Need: To help older patients with chronic conditions learn to manage their illnesses and thereby reduce hospital readmissions in Oconee County, South Carolina.
  • Intervention: Community volunteers trained as health coaches mentor discharged patients with certain chronic conditions, to help them transition from home health care to self-care.
  • Results: Participants had improved health behaviors and reduced readmissions.

Other Project Examples

funded by the Federal Office of Rural Health Policy Worcester County Health Department Aging Initiative
Updated/reviewed August 2017
  • Need: Worcester County, Maryland's older residents were experiencing a lack of affordable and easily-accessible in-home care and behavioral health services.
  • Intervention: The Worcester County Health Department created the Aging Initiative project in order to increase access and utilization of home care and behavioral health services for older adults in the area.
  • Results: The Aging Initiative expanded access to home care services, financial assistance for medical equipment, and provided nearly 100 people with behavioral healthcare services.
Granville Health System's Transitional Care Program
Added April 2017
  • Need: To reduce hospital admissions and improve health for North Carolina patients.
  • Intervention: Granville Health System's Transitional Care Program helps hospital and ED patients schedule follow-up appointments. In addition, the program provides home visits and safety checks.
  • Results: From 2015 to 2016, the number of patients receiving home visits increased from 30 to 86. In addition, 2016 saw a $73,595 reduction in inpatient readmissions and an $11,500 reduction in self-pay readmissions of patients with high-risk diagnoses.
Eagle County Community Paramedic
Updated/reviewed February 2017
  • Need: Rural areas nationwide have shortages of primary care providers and home health programs.
  • Intervention: Eagle County Paramedic Services is utilizing community paramedics in the provision of non-acute home care and assistance with immunizations and screenings in rural areas where it is difficult for these services to be accessed.
  • Results: The pilot program was featured at the 2010 International Roundtable on Community Paramedicine. After 18 months of implementing the program, a net total of $288,028 in healthcare costs was saved.
Mobile Medication Program for Patients with Mental Illness
Updated/reviewed November 2016
  • Need: To assist individuals with mental illness in managing medication independently and to reduce hospitalization costs of treating individuals with serious mental illness.
  • Intervention: Mobile medical staff provide education, support, and skill-building to assist individuals with medication management.
  • Results: A reduction in area hospitalization costs and a reduction in the need for long-term hospitalization among program participants.
funded by the Federal Office of Rural Health Policy Telehealth Monitoring in Home Health
Updated/reviewed April 2016
  • Need: For recently hospitalized patients with complex, chronic illnesses, telehealth remote patient monitoring allows for more effective management of patients' conditions between provider visits.
  • Intervention: Telehealth remote patient monitoring gathers and trends vital signs and other data and delivers disease-specific education and surveys to homebound patients.
  • Results: Telehealth remote patient monitoring has reduced hospitalizations, reduced emergency department visits, reduced healthcare costs, improved clinical outcomes, and improved quality of life for complex patients with chronic illnesses.