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ARcare Aging Well Outreach Network

  • Need: To reduce falls and improve chronic care management for adults 50 or older in rural Cross County, Arkansas.
  • Intervention: The ARcare Aging Well Outreach Network, run by an FQHC, provides services like falls prevention assessments, transportation to appointments, medication management, and senior-specific exercise opportunities.
  • Results: From May 2015 to December 2017, the network served 584 patients.


Promising (About evidence-level criteria)


In rural Cross County, Arkansas, population of around 16,800 people, more than 7,500 people are 50 years old or older. Community needs assessments show that this population would benefit from falls prevention programs, medication management, chronic disease self-management education, and exercise opportunities designed for older adults.

The Federally Qualified Health Center (FQHC) ARcare runs the ARcare Aging Well Outreach Network, which works to ensure that this population, especially those with chronic diseases, are able to improve their health and to age in place. The outreach network works with ARcare's Longevity Center, a medical home that focuses on older patients' primary care needs. This center provides:

  • Case managers
  • Falls prevention assessment and planning
  • Geriatric specialist
  • Home health coordination
  • Medication reconciliation
  • Transportation to appointments and exercise opportunities
  • Wellness and fitness center

The outreach network received funding from a 2015-2018 Federal Office of Rural Health Policy (FORHP) Rural Health Care Services Outreach grant as well as private foundation money.

Services offered

ARcare identifies patients who would benefit from the Aging Well Outreach Network. This network provides:

  • Cooking classes
  • Chronic disease support groups
  • Exercise opportunities designed for older adults
  • Falls prevention assessment and education
  • Medical equipment like walkers and canes
  • Medication management
  • Nutrition education
  • Transportation
ARcare patient and treadmill
An ARcare staff member helps a patient with the treadmill at the fitness center.


From May 2015 to December 2017, the network served 584 patients through 1,296 medical encounters. Of these 584 patients:

  • 258 have improved their blood pressure rates
  • 244 were diagnosed with diabetes, 174 of whom have improved their A1C levels
  • 273 received medication management services, with 210 receiving changes to their medications as a result
  • 200 have used the fitness center
  • 100% of these patients have had a falls risk assessment each year

ARcare has provided three community training events that focus on age-appropriate screenings, driver education safety for older adults, and the differences between Alzheimer's and dementia.

The outreach network is also featured as a program model in RHIhub's Aging in Place Toolkit.


One challenge was securing patient buy-in. Patients were a little skeptical of the services at first, but once they learned about the different services and the opportunity for a longer appointment with their provider, they were on board.

Patient and ARcare staff
A patient poses with ARcare staff.


Gain community buy-in through community outreach (public relations), and collaborate with other local organizations to better provide resources to older adults.

Since appointments are longer, providers might not see as many patients during the day. Remind them that a longer appointment allows them to treat the whole patient, not just one specific illness.

Contact Information

Carrie Fortune, Director of Grants Management

Aging and aging-related services
Chronic disease management
Elderly population
Federally Qualified Health Centers
Wellness, health promotion, and disease prevention

States served

Date added
February 23, 2018

Date updated or reviewed
March 5, 2019

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.