Rural Project Examples Addressing Service delivery models

Updated/reviewed February 2026

Need: Arkansas had high rates of low birthweight babies, and pregnant patients in rural areas had difficulty accessing specialty obstetric care.
Intervention: The University of Arkansas for Medical Sciences (UAMS) created the Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program to increase access to care for pregnant patients in an effort to improve outcomes for high-risk pregnancies.
Results: The program has increased access to care and improved neonatal outcomes for rural Arkansas individuals through a variety of programs and has been recognized by various organizations as a model program.

Updated/reviewed November 2025

Need: To help people with chronic conditions learn how to manage their health.
Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.

Updated/reviewed May 2025

Need: To enhance palliative care access to rural patients with serious illness, such as advanced cancer, heart failure, and COPD, and their family caregivers.
Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led or palliative care coach/navigator sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
Results: Patients and caregivers report higher quality of life and lower rates of depression and (caregiver) burden.

Updated/reviewed April 2025

Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.

Updated/reviewed February 2024

Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.

Updated/reviewed March 2026

Need: Improve healthcare access and decrease chronic disease disparities in rural Appalachia.
Intervention: A unique community health worker-based chronic care management program, created with philanthropy support.
Results: After a decade of use in attending to population health needs, health outcomes, healthcare costs, in 2024, the medical condition-agnostic model has a 4-year track record of financial sustainability with recent scaling to include 31 rural counties in a 3-state area of Appalachia and recent implementation in urban areas.

Updated/reviewed March 2026

Need: To increase access to medical screening for miners in New Mexico.
Intervention: A mobile screening clinic with telemedicine capability screens miners for respiratory and other conditions.
Results: In a survey, 92% of miners reported their care as very good, while the other 8% reported it as good. The program has expanded to three other states.

Updated/reviewed January 2026

Need: Improve health and wellness outcomes for those affected by trauma and adverse experiences.
Intervention: A language, traditions, and customs-specific evidence-based peer support model that trains local communities on education and prevention strategies to address and heal the effects of trauma.
Results: Peer-reviewed results show decreases in emergency room visits and hospitalizations, over 50% reduction of trauma symptomology, decreases in unhealthy substance use, and improvements in family and spiritual well-being. Model elements have adapted in Canada and several Lower 48 states.

Updated/reviewed January 2026

Need: Meeting the health needs of an expanding older adult population in rural Livingston County, New York.
Intervention: In 2006, a federal grant was leveraged to create the Help For Seniors program that focused on EMT training for performing in-field health needs assessments for older adults and the support for a case management staff to address those screening results.
Results: Based on over 1200 older adult evaluations and the training of nearly 200 EMTs, the project's results and capacity building became a foundation for continued similar county activities that are now supported by state funding.

Updated/reviewed November 2025

Need: In the early 2010s, needed increase access to medication treatment for opioid use disorder in rural Vermont.
Intervention: 2012-2016 implementation of a statewide hub-and-spoke treatment access system.
Results: The original system's increased treatment capacity and care coordination successes now are a permanent system of integrated care overseen by the Vermont state health department and Vermont Blueprint for Health.

Rural Project Examples: Service delivery models