Rural Project Examples: Service delivery models
Promising Examples
TelePrEP
Updated/reviewed May 2025
- Need: To prevent new cases of HIV in rural Iowa.
- Intervention: TelePrEP provides preventive care via telehealth and prescription delivery.
- Results: Between February 2017 and August 2020, TelePrEP received 456 referrals, with 403 patients completing an initial visit.
Arkansas Rural Health Partnership Hospital-Based Transitional Care Program
Added August 2024
- Need: Solutions for Medicare beneficiaries' post-acute care recovery gaps in Arkansas's southeast Delta Region.
- Intervention: Supported by federal funding and their membership organization, seven hospitals implemented an evidence-supported Critical Access Hospital transitional care model.
- Results: Participating hospitals found a significant increase in swing bed services revenue, an all-cause low readmission rate, high percentage of patients discharged to home or to an assisted living environment, and positive patient satisfaction surveys.
Cross-Walk: Integrating Behavioral Health and Primary Care
Updated/reviewed May 2024
- Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
- Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
- Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.
Other Project Examples
ASPIN's Certified Recovery Specialist Program
Updated/reviewed September 2026
- Need: Indiana's rural communities face significant behavioral health and primary care shortages. Providers require trained frontline workers who can support care navigation, address social drivers of health, and expand access to prevention, intervention, and recovery services.
- Intervention: A statewide training and workforce development model that certifies Community Health Workers (CHWs) and dual CHW/PRSS (Peer Recovery Support Specialists) to serve in rural settings.
- Results: ASPIN has trained and certified 2,235 Community Health Workers, expanded PRSS training opportunities, and supported rural partners statewide through CHW training and workforce development programs.
Indiana ASPIN Veteran's Services
Updated/reviewed September 2026
- Need: To address the lack of mental healthcare options for rural veterans.
- Intervention: A telebehavioral health hub network was created to connect community mental health centers to the VA Medical Center.
- Results: More than 3,000 telehealth appointments have been made, saving hundreds of veterans time and money.
Major Health Partners Kidney Care Options (KCO) Program
Added July 2026
- Need: To improve kidney care for patients in rural Indiana.
- Intervention: A nurse-led, interdisciplinary kidney care program redesigned clinical workflows to identify patients earlier, provide education, address barriers to treatment, and support informed decision-making.
- Results: From 2023 to 2025, 80% to 92% of patients received Kidney Care Options education before initiating kidney replacement therapy.
Auburn University Rural Health Initiative
Updated/reviewed June 2026
- Need: To expand healthcare access in rural Alabama communities.
- Intervention: The Auburn University Rural Health Initiative is working with communities across Alabama to develop a healthcare model that includes primary care, substance use disorder treatment and mental health treatment via state-of-the-art telehealth technologies, coupled with health and wellness programs and services provided by faculty and students.
- Results: To date, there are five telehealth care stations open, located in LaFayette, Boligee, Akron, Catherine, and Gainesville, Alabama. These stations have impacted over 8,207 individuals, with 284 community events, 3,565 patient consultations, and 50 new health ambassadors.
Intersect: Individualized Collaborative Drug Therapy Program
Added May 2026
- Need: To make sure patients with chronic conditions are educated about, and able to manage, their medical prescriptions and care.
- Intervention: A rural primary care-based program that uses a multidimensional team approach to connect rural patients with clinical pharmacists via telehealth.
- Results: More than 250 patients have participated in the program.
Queen Anne's County Mobile Integrated Community Health (MICH) Program
Updated/reviewed May 2026
- Need: To connect patients to resources in order to reduce use of emergency services, emergency department visits, and hospital readmissions.
- Intervention: Patients receive support (by in-person visit, phone call, or telehealth visit) from a paramedic, community health nurse, peer recovery specialist, and pharmacist.
- Results: Between July 2016 and March 2024, the program made 1,098 patient contacts and continued to see a reduction in emergency department and inpatient visits and costs.
The Minnesota Integrative Behavioral Health Program
Updated/reviewed May 2026
- Need: Out of 79 Critical Access Hospitals (CAHs) surveyed in Minnesota in 2015, behavioral health was the most frequently cited service requested.
- Intervention: In response, Rural Health Innovations launched the Minnesota Integrative Behavioral Health Program. This initiative engaged representatives across all sectors in health integration between hospital, primary care, and community services.
- Results: Strategy sessions resulted in the creation of resource directories to improve care coordination, evaluation measurements to document results, and an overall better understanding of integrative care challenges.
For examples from other sources, see:
