Skip to main content

Rural Health Models and Innovations Funded by the Federal Office of Rural Health Policy

A collection of rural health projects that received support from the Federal Office of Rural Health Policy:

Promising Examples

Prevention through Care Navigation Outreach Program
Updated/reviewed May 2020
  • Need: To reduce the prevalence of diabetes and cardiovascular disease in rural Colorado.
  • Intervention: Community Health Workers are utilized to create a system of coordinated care in Delta, Montrose, Ouray, and San Miguel counties.
  • Results: As of 2018, 2,709 people have been screened for diabetes and cardiovascular disease, with many at-risk patients lowering cholesterol, blood pressure, and A1C levels after engaging with a Community Health Worker.
The Rural Virtual Infusion Program
Updated/reviewed April 2020
  • Need: Allow rural cancer patients in a region inclusive of 26 counties in Iowa, Minnesota, and South Dakota to have access to tertiary-level chemotherapy regimens in rural infusion centers.
  • Intervention: With telehealth-based oversight from a tertiary care oncology team, 3 rural infusion teams were trained to coordinate cancer treatment plans and administer complex chemotherapy regimens.
  • Results: Almost 130 patients were transitioned to receive chemotherapy in a rural infusion center, translating to over 1,000 infusion visits and saving patients/families nearly 65,000 trip miles, 1,800 travel hours and $71,000.
ARcare Aging Well Outreach Network
Updated/reviewed March 2020
  • 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, provided services like falls prevention assessments, transportation to appointments, medication management, and senior-specific exercise opportunities.
  • Results: From May 2015 to April 2018, the network served 639 patients through 1,580 medical encounters.
The Health Wagon
Updated/reviewed February 2020
  • Need: Healthcare access for the medically underserved in Central Appalachia.
  • Intervention: A mobile clinic that provides free healthcare in 11 rural Virginia communities.
  • Results: The Health Wagon provides comprehensive healthcare services to over 4,000 patients annually.
Health Coaches for Care Transition
Updated/reviewed December 2019
  • 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.
Healthy Outcomes Integration Team
Updated/reviewed December 2019
  • Need: To provide integrated treatment planning and coordinated healthcare services to rural residents.
  • Intervention: The Healthy Outcomes Integration Team was designed to treat adults who have a serious mental health condition and those who have, or are at risk of developing, chronic health conditions.
  • Results: Clients received coordinated care, substance abuse treatment, crisis services, and wellness planning. Many also improved their physical health outcomes.
Youth4Health
Updated/reviewed December 2019
  • Need: To educate youth about obesity and healthy lifestyle choices.
  • Intervention: An educational program about healthy living was implemented in Lincoln and Claiborne Parishes in Louisiana for youth ages 9-18.
  • Results: Youth4Health program produced greater awareness and participation in healthier lifestyles by target youth and their families, as well as church congregations.
Healthy Connections, Inc. Healthy Families Arkansas
Updated/reviewed November 2019
  • Need: High poverty rates and lack of access to healthcare make caring for unborn and newborn children difficult for young mothers in Arkansas's Polk and Garland Counties.
  • Intervention: An Arkansas-based program provides a national healthcare service to expectant and young mothers. Prenatal check-ups, education, transportation, well-baby checks and child immunizations are all provided by the Healthy Connections, Inc.
  • Results: The program's results demonstrate an increase in first trimester prenatal care rates and child immunization rates, as well as a dramatic decrease in confirmed cases of child abuse.
Nurse Navigator and Recovery Specialist Outreach Program
Updated/reviewed November 2019
  • Need: To properly address and treat patients who have concurrent substance abuse and chronic healthcare issues.
  • Intervention: A referral system utilizes community health workers (CHWs) in a drug and alcohol treatment setting. A registered nurse helps with providers' medication-assisted treatment programs.
  • Results: This program has reduced hospital emergency visits and hospital readmissions for patients since its inception.
Bridges to Health
Updated/reviewed October 2019
  • Need: To reduce barriers to accessing healthcare for immigrant farmworkers in the rural areas of Vermont.
  • Intervention: Bridges to Health uses care coordination and health promoters to reduce barriers to accessing healthcare on an individual level. The program offers targeted technical assistance to address systemic barriers at health access points in areas with high numbers of immigrant farmworkers.
  • Results: Some barriers to accessing healthcare have been reduced or removed for immigrant farmworkers in certain counties.