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Other Case Studies and Collections of Program Examples: Access

In addition to RHIhub's Rural Health Models and Innovations rural program examples, you may also want to browse other case studies, databases, and websites with collections of health programs.

Each resource listed below uses its own criteria for selecting program examples, which may range from programs known to be effective based on research to anecdotal accounts. In each resource, you may want to review information on the level of evidence required for a program's inclusion.

May include non-rural programs that could be applicable to rural health delivery.

Wilson Medical Center Implements Creative Care Alternatives to Address COVID-19
Describes Wilson Medical Center's implementation of curbside and telehealth services in response to COVID-19 in rural Kansas. Offers lessons learned from the transition to alternative solutions and future goals for adapting healthcare services as needed.
Date: 04/2020
Type: Document
Sponsoring organization: American Hospital Association
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Rural Community Action Guide: Building Stronger, Healthy, Drug-Free Rural Communities
Provides an overview of challenges rural communities face related to substance use disorder (SUD), including prescription opioid misuse. Identifies action steps rural communities can take related to prevention, treatment, recovery, and SUD-related issues such as stigma, transportation barriers, and lack of employment opportunities. Features programs that are working to address these issues in rural communities.
Additional links: Promising Practices Supplement
Date: 01/2020
Type: Document
Sponsoring organization: Office of National Drug Control Policy (ONDCP)
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The Value Initiative Members in Action: Dartmouth-Hitchcock Medical Center - Lebanon, N.H
Describes how the Dartmouth-Hitchcock Medical Center partners with rural and community hospitals to provide telehealth specialty care services across northern New England through the Dartmouth-Hitchcock Connected Care program. Discusses clinical outcomes and patient satisfaction with the telehealth programs. Examines how telehealth services impact staffing and services offered in small and rural hospitals.
Date: 12/2019
Type: Document
Sponsoring organization: American Hospital Association
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Serving Rural America: Health Insurance Providers at Work
Offers 5 case studies to showcase the ways in which health insurance providers are working to ensure access to high quality healthcare in rural areas. Examples feature 8 insurance providers in Maryland, Pennsylvania, California, and Oregon sharing different approaches to healthcare delivery, financing, and community engagement.
Date: 09/2019
Type: Document
Sponsoring organization: America's Health Insurance Plans
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Exploring Bright Spots in Appalachian Health: Case Studies
In-depth studies of 10 Appalachian counties with health outcomes that are better than expected, given their characteristics and resources. Identifies actions these areas are taking to improve health and well-being. Features statistics including demographics and health-related data, and maps showing economic status of Appalachian counties. Third in a series of reports exploring health issues in Appalachia.
Author(s): Nancy M. Lane, G. Mark Holmes, Thomas A. Arcury, et al.
Date: 07/2018
Type: Document
Sponsoring organizations: Appalachian Regional Commission, Burness, PDA, Inc., The Cecil G. Sheps Center for Health Services Research
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Telepsychiatry Program: Children's Hospital and Medical Center
Describes the development, impact, lessons learned, and future goals of a telepsychiatry program designed to provide behavioral healthcare services to children in rural Nebraska.
Date: 07/2018
Type: Document
Sponsoring organization: American Hospital Association
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Promising Practice: Alabama SORH Collaborates with VA to Provide Telehealth Care for Vets
Describes a collaboration between the Alabama State Office of Rural Health and Alabama Veterans Affairs to create and implement a telehealth program aimed at delivering care to rural veterans.
Author(s): Beth Blevins
Date: 06/2018
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Ensuring Access and Improving Population Health Through Collaboration and Patient - Centered Care Columbia Memorial Hospital, Astoria, OR
Describes Columbia Memorial Hospital (CMH), an independent Critical Access Hospital (CAH), in Astoria, Oregon, that works to ensure access to specialty and primary care for Pacific North Coast and Lower Columbia regions of northwest Oregon. Shares strategies and collaborative efforts to address the community's needs by ensuring access to care, improving population health, and designing consumer driven patient-centered care.
Date: 05/2018
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Ensuring Access to Care: Wagner Community Memorial Hospital – Avera, Wagner, S.D.
Describes Wagner Community Memorial Hospital – Avera (WCMH-A), a 20-bed Critical Access Hospital (CAH) in Wagner, South Dakota, that works to ensure access to care while addressing the social determinants of health for the populations they serve. Shares strategies and collaborative efforts to address the community's needs through the use of telemedicine, housing and economic development, population health, and access to primary care.
Date: 05/2018
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Expanding Care for Rural Patients
Discusses the telehealth psychology program at Texas A&M and the effect the program has had on mental health access across the state. Details the program's implementation and the ways it is overcoming barriers for rural people.
Author(s): Amy Novotney
Citation: APA Monitor on Psychology, 49(3), 64
Date: 03/2018
Type: Document
Sponsoring organization: American Psychological Association
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Kalispell Regional Healthcare: Managing the Needs of Medically and Socially Complex Patients or Superutilizers
Details how Kalispell Regional Healthcare teamed with Mountain-Pacific Quality Health to introduce a modified transitional care model, which is designed to reduce service utilization and improve the health of high-cost, high-need patients. Initiative is part of a special innovations project through the Centers for Medicare and Medicaid Services (CMS) and uses multidisciplinary "ReSource" teams to coordinate care and services across rural and underserved areas of Montana.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Ensuring Access with a Hospital's Conversion to a Freestanding Emergency Department
Outlines Ellijay, Georgia-based North Georgia Medical Center's transition from a traditional community hospital to a freestanding emergency department (ED). Shares administrative, legal, and logistical challenges that, once overcome, resulted in Piedmont Mountainside Hospital Emergency Services - a successful, community-focused, freestanding ED.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Network Spotlight: Illinois Telehealth Network
Describes the characteristics, lessons learned, and accomplishments of the Illinois Telehealth Network (ITN) through an interview with key ITN personnel. ITN is a 26-member consortium of rural health entities, including Critical Access Hospitals (CAHs) and Federally Qualified Health Centers (FQHCs), working to improve access to care in rural, underserved communities through the expanded application of telehealth and telemedicine solutions.
Date: 11/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Rural Transportation Best Practice: Transportation for Individuals with Chronic Care Conditions
Highlights a program called Mountain Empire Older Citizens (MEOC), which is a transportation assistance service for individuals with chronic conditions in Big Stone Gap, VA. Details the demographics of the town, as well as the structure of the program.
Date: 10/2017
Type: Document
Sponsoring organization: National Aging and Disability Transportation Center
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A Community Holding Hands to Bridge its Divide
Describes the actions taken and programs developed by the residents of Garrett County, Maryland, in response to the economic, cultural, and health challenges they face. Working together, the Garret County residents have been able to provide scholarships to every high school graduate to attend community college for free, develop 700 affordable, low-income, mixed-income, and workforce housing units, and more. Garrett County is a recipient of the 2017 Robert Wood Johnson Foundation's Culture of Health Prize.
Date: 09/2017
Type: Document
Sponsoring organization: Robert Wood Johnson Foundation
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Innovations in Rural Health System Development: Federally Qualified Health Center Initiatives
Reports on Maine's Federally Qualified Health Centers (FQHCs). Discusses strategies for workforce recruitment and retention, serving high-need patient populations, addressing critical community needs, and providing services that address the social determinants of health. Provides various examples of programs from across the state.
Author(s): Sara Kahn-Troster, Amanda Burgess, Andrew Coburn
Date: 09/2017
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Muskie School of Public Service Cutler Institute for Health and Social Policy
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Tackling the Opioid Crisis in a Rural Community
Discusses a partnership between a rural hospital physician and the director of a community counseling center to establish a medication-assisted treatment (MAT) for opioid addiction in rural Maine. Presents the program's support structure, as well as the advantages of having an integrated treatment approach.
Date: 09/2017
Type: Document
Sponsoring organization: American Hospital Association
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An Assessment of Mobile and Portable Dentistry Programs to Improve Population Oral Health
Describes configurations of portable and mobile dental programs including models and applications, discusses targeted populations, details variations in regulations by state, and examines outcomes of preventive interventions in underserved areas. Includes case studies of 7 programs initiated to improve access in underserved populations or in rural areas.
Additional links: Policy Brief
Author(s): Margaret Langelier, Jean Moore, Rachel Carter, et al.
Date: 08/2017
Type: Document
Sponsoring organization: Oral Health Workforce Research Center
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Network Spotlight: North Dakota Critical Access Hospital Quality Network
Describes the North Dakota Critical Access Hospital (CAH) Quality Network through an interview with Senior Project Coordinator, Jody Ward, and Associate Director, Lynette Dickson, from the University of North Dakota School of Medicine and Health Sciences' Center for Rural Health. The North Dakota CAH Quality Network serves as a voluntary platform for facilitating best practices and quality improvement initiatives across all of North Dakota's 36 CAHs. Focuses on the North Dakota CAH Quality Network's characteristics, lessons learned, accomplishments, and challenges.
Date: 08/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Rural Promising Practice Issue Brief: Interdisciplinary Clinical Video - Telehealth for Geriatrics and Dementia
Highlights the development, implementation, and evaluation of an interdisciplinary telehealth program designed to help caregivers provide coordinated care for aging rural veterans suffering from dementia. Discusses the interdisciplinary team model comprised of social workers, geriatricians, primary care providers, and rural caregivers coordinating to maintain a uniform level of care. Includes outcomes regarding the increase of access to education and caregiver support, as well as the ability of providers to prescribe medication to rural patients.
Additional links: Overview
Date: 05/2017
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Network Spotlight: Northeast Oregon Network (NEON)
Highlights a conversation with Lisa Ladendorff, the executive director of the Northeast Oregon Network (NEON). NEON is a nonprofit health collaborative serving five rural and frontier counties in eastern Oregon that work to improve health outcomes in the region. Discusses challenges encountered, past successes, advice for developing rural health networks, and more.
Date: 05/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Lessons Learned: A Rural Case Study - Challenges Increasing Access to Dental Care Among Rural Veterans
Details the referral process initiated by the Grand Island Dental Outpatient Team in Nebraska for rural veterans who are ineligible for VA dental coverage to receive basic treatment from community dentists. Discusses some of the challenges to designing and implementing the program, such as establishing new partnerships with local dentists, adhering to a sustainable staffing plan, and pursuing data collection and analysis for measuring outcomes, among other factors.
Date: 05/2017
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Network Spotlight: Northwest Rural Health Network
Presents information from an interview with Jac Davies, the executive director of the Northwest Rural Health Network based in Spokane, Washington. Highlights how the Northwest Rural Health Network supports its members by sharing information and promoting efficient models of integrated care. Discusses member benefits, challenges faced, advantages of working in a rural environment, advice for developing rural health networks, and more.
Date: 04/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Network Spotlight: Affiliated Service Providers of Indiana (ASPIN)
Highlights an interview with Kathy Cook, CEO and President of the Affiliated Service Providers of Indiana (ASPIN). ASPIN is a network of community health centers and addiction providers serving rural areas of Indiana. Interview focuses on sharing information about the network's characteristics, challenges faced, accomplishments, lessons learned, recommendations for other networks, and more.
Date: 03/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Global Budget Process as an Alternative Payment Model
Analyzes the all-payer hospital rate-setting system of McCready Health in rural Maryland. Discusses the Total Patient Revenue (TPR) system and corresponding essential functions such as rate setting, strategic planning, and care coordination.
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Value
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Network Spotlight: Appalachian Kentucky Health Care Access Network
Explores various aspects of the Appalachian Kentucky Health Care Access Network (AKHCAN) through an interview with Project Director Jan Chamness, and Project Manager Gina Brien. The AKHCAN is a grant-funded network that seeks to increase and improve healthcare access for all low-income, uninsured, and underinsured populations living in rural Kentucky through the use of community health workers (CHWs).
Date: 02/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Network Spotlight: Foothills Health Network
Provides an overview of the Foothills Health Network in Polk County, North Carolina, through an interview with network coordinator, Michele Trofatter. The Foothills Health Network works to improve the health of people living in Polk County by increasing access to care, particularly within the low-income and uninsured populations. Interview covers challenges faced, successes, lessons learned, network characteristics, recommendations for other networks, and more.
Date: 01/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Compendium of Rural Oral Health Best Practices - 2017
Presents examples of the best practices in rural oral healthcare across the country. Looks at programs in 10 different states, including program purpose, summary, effectiveness, and funding source.
Date: 2017
Type: Document
Sponsoring organization: National Rural Health Association
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Case Studies of 6 Teledentistry Programs: Strategies to Increase Access to General and Specialty Dental Services
Describes the delivery of teledentistry services by six provider organizations with different organizational structures. Discusses teledentistry as a method for improving rural access to oral health services. Identifies common themes, including the benefits of and barriers to teledentistry.
Additional links: Policy Brief
Author(s): Margaret Langelier, Carol Rodat, Jean Moore
Date: 12/2016
Type: Document
Sponsoring organization: Center for Health Workforce Studies
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Rural Promising Practice Issue Brief: Using Clinical Video Telehealth to Provide Comprehensive Care to Rural Veterans with Multiple Sclerosis (MS)
Presents a report on the VHA's use of video telehealth in clinical settings to provide access to treatment for rural veterans with Multiple Sclerosis (MS). Discusses implementation strategies and the roles of neurologists, physical therapists, and telehealth support staff.
Additional links: Overview
Date: 11/2016
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Rural Promising Practice Issue Brief: Remote, Telephone-Based Delivery of Cardiac Rehabilitation
Presents a model from the VHA that uses telemedicine to provide cardiac rehabilitation to rural veterans. Highlights the three phases of the program that facilitate patient rehabilitation from hospitalization to regular check ups.
Additional links: Overview
Date: 11/2016
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Rural Promising Practice Issue Brief: Training Community Clergy Partners to Increase Access to Care for Rural Veterans
Presents a toolkit and web-based module for the development, implementation, and evaluation of a mental health training program for clergy to help rural veterans. Discusses in-person and web-based training methods implemented in the pilot program. Includes outcomes regarding the increase of access to mental healthcare and clinical impact for rural veterans, among other factors.
Additional links: Overview
Author(s): James Goalder, Kristen Wing, Eric Crawford, Keith Ethridge
Date: 11/2016
Type: Document
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Innovations in Rural Health System Development: Service Delivery Advances in Care Coordination, Emergency Care, and Telehealth
Offers examples of emergency services, telehealth technology, and care coordination initiatives with a focus on Maine, and how they impact rural service delivery and safeguard rural access to critical health services.
Author(s): Amanda Burgess, Andrew Coburn
Date: 10/2016
Type: Document
Sponsoring organizations: Maine Health Access Foundation, Maine Rural Health Research Center
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Integrated Care in a Frontier Community
Examines the Southeast Health Group (SHG) in La Junta, Colorado, which coordinates physical and behavioral health using patient-centered, wellness-based care coordination to empower patients and promote self-directed care. Focuses on hiring providers who share SHG's philosophy of care, using community resources, and engaging peer support specialists.
Date: 07/2016
Type: Document
Sponsoring organization: Rural Health Value
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15 Million Kids in Health Care Deserts: Can Telehealth Make a Difference?
Highlights healthcare access problems for children of vulnerable populations living in rural and poverty stricken areas. Discusses how telehealth can be implemented to overcome these barriers. Describes several case studies focused on improving access to healthcare services for children, including a rural school-based telehealth program.
Author(s): Dale Alverson, Julie Hall-Barrow, Denise M. Dion, et al.
Date: 04/2016
Type: Document
Sponsoring organization: Children's Health Fund
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Integration of Oral Health with Primary Care in Health Centers: Profiles of Five Innovative Models
Report highlights five different FQHC-based models for integrating oral healthcare into primary care. Features examples in both rural and urban locations.
Author(s): Hannah Maxey
Date: 2015
Type: Document
Sponsoring organization: National Association of Community Health Centers
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Rural Healthy People 2020: A Companion Document to Healthy People 2020, Volume 1
Provides a rural focus for the Healthy People 2020 priorities. Includes overviews of the top 10 rural health priority areas identified by rural stakeholders. (Volume 2 discusses priorities 11-20.) Topics addressed include: health insurance, primary care, emergency services, nutrition and weight status, diabetes, mental health, substance abuse, heart disease and stroke, physical activity, older adults, maternal and child health, and tobacco use. Each overview includes reviews of the relevant literature and models that rural communities can use to address the issues. Document is available for free download, after providing brief information about intended use.
Author(s): Jane N. Bolin, Gail Bellamy, Alva O. Ferdinand, Bita Kash, Janet W. Helduser
Date: 2015
Type: Document
Sponsoring organization: Southwest Rural Health Research Center
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Assessing the Feasibility of a Virtual Tumor Board Program: A Case Study
Examines the feasibility of a Virtual Tumor Board (VTB) program connecting rural community clinicians to the University of North Carolina Lineberger Comprehensive Cancer Center (UNC LCCC) tumor board. Analyzes the individual clinical participants to explore their experiences with the VTB. Includes a summary of data collection methods, coding of interview data, and UNC tumor board participant survey results.
Author(s): Christopher M. Shea, Randall Teal, Lindsey Haynes-Maslow, et al.
Citation: Journal of Healthcare Management, 59(3), 177-193
Date: 2014
Type: Document
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Network Dispenses Hope, Prescription Drugs to Low-Income Patients
Highlights the Dispensary of Hope which distributes donated surplus medications to its national network of licensed nonprofit clinics and charitable outpatient pharmacies.
Author(s): Candi Helseth
Citation: Rural Monitor
Date: 11/2013
Type: Document
Sponsoring organization: Rural Health Information Hub
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Local Programs Help Patients Navigate Medical Care
A look at patient navigator programs in four states: a statewide program in Georgia, a program in Kentucky for cervical cancer patients, a promotores program in Texas for chronic conditions, and a coordinated care program for cancer patients in Vermont.
Author(s): Candi Helseth
Citation: Rural Monitor
Date: 05/2012
Type: Document
Sponsoring organization: Rural Health Information Hub
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Mobile EMS Lab Improves Critical Care in Nevada's High Desert
Highlights Humboldt General Hospital Emergency Medical Services (HGH-EMS), which is taking ultrasound and lab out in the field to improve patient outcomes in rural areas.
Author(s): Candi Helseth
Citation: Rural Monitor
Date: 11/2011
Type: Document
Sponsoring organization: Rural Health Information Hub
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Improving Access to Care for Medically Underserved Californians: Securing Health Professional Shortage Area (HPSA) Designations
Describes an initiative to increase healthcare provider capacity in medically underserved areas throughout the service areas of the North Coast Clinics Network (NCCN), made up of four Federally Qualified Health Centers (FQHCs) and one community clinic. Discusses issues recruiting healthcare providers to rural areas.
Author(s): Annette L. Gardner, Tina Tvedt
Date: 01/2010
Type: Document
Sponsoring organization: California Endowment
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Impact of Seasonal Population Variations on Frontier Communities: Maintenance of the Healthcare Infrastructure
Provides findings from three case studies of frontier communities with seasonal population variations: Skagway, Alaska; Quartzsite, Arizona; and Lake City/Hinsdale County, Colorado. Discusses the experiences of these communities in meeting the health care needs of the permanent local population and seasonal residents and visitors.
Date: 04/2006
Type: Document
Sponsoring organization: National Center for Frontier Communities
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VHA-ORH Rural Promising Practices
A compendium describing proven models of care currently implemented to improve access to care and specialty care for rural veterans and their families within their own communities. Provides clinical and operational information about these models for healthcare professionals serving rural veterans.
Type: Website
Sponsoring organization: Veterans Health Administration's Office of Rural Health
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Tribal Members Access Care and Address Health Problems
Highlights the Coharie Health Access, Improvement and Awareness Project, established by the Coharie Indian Tribe, and designed to increase access to healthcare and promote health literacy among tribal members. Details methods of healthcare delivery and services provided over the project's two-year period.
Type: Document
Sponsoring organization: Administration for Native Americans
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Case Study: Paramedicine Program Strengthens Rural Health Care System
Shares how leaders of Community Hospital in rural McCook, Nebraska reached their goal of reducing ambulance transports, emergency room visits, and hospital readmissions by partnering with community organizations to create the McCook Community Paramedicine program. Focuses on program's approach, key steps, lessons learned, and results.
Type: Document
Sponsoring organization: Bryan Health
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Compendium of Hospital & Community Partnerships
Outlines a number of innovative partnerships between rural hospitals and community organizations in Nebraska that work to expand local services, improve care quality, and reduce the cost of care in rural communities. Presents partnerships in case study format, sharing key steps, lessons learned, and project results.
Type: Website
Sponsoring organization: Bryan Health
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AHA Community Connections
Provides access to case studies spotlighting hospitals and health systems (some are in rural areas) that have successfully collaborated with local community organizations to promote care coordination, wellness, and prevention. Website also includes tools and resources to help healthcare facilities be accountable and transparent to their communities and deliver quality care.
Type: Website
Sponsoring organization: American Hospital Association
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