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Rural Project Examples: Service delivery models

Promising Examples

Patient Centered Medical Home Practicum in Primary Care
Updated/reviewed May 2019
  • Need: Improvement in service quality and patient experience in primary care practices in North Carolina's Blue Ridge region and across the state.
  • Intervention: A practicum for healthcare management students was developed to help rural practices achieve Patient Care Medical Home (PCMH) status, identify quality improvement needs, and develop strategies.
  • Results: With the help of practicum students, rural primary practices have have tackled a number of important quality improvement projects, achieved PCMH status and Blue Quality Physician Program Recognition.
funded by the Federal Office of Rural Health Policy TeleStroke/Vascular Neurology Patient Navigator Program
Added March 2019
  • Need: Improve post-hospital stroke care access in order to improve physical function and well-being for stroke patients living in a 6-county area in rural Minnesota.
  • Intervention: Implementation of an evidence-based patient navigator program paired with telehealth services for post-hospital care of rural stroke patients.
  • Results: In addition to other successes, more than 120 individuals enrolled in the navigator program, the Modified Rankin Score assessments at baseline and 6 months showed functional improvements.
funded by the Federal Office of Rural Health Policy The Health-able Communities Program
Added March 2019
  • Need: Expand healthcare access for the more remote residents of 3 frontier counties in north central Idaho.
  • Intervention: Consortium of healthcare providers and community agencies used a hybrid Community Health Worker model to augment traditional healthcare delivery services in order to offer a diverse set of healthcare offerings to frontier area residents.
  • Results: Increased healthcare access, especially for cancer and chronic disease screening, along with providing education on a diverse array of health topics.
funded by the Federal Office of Rural Health Policy Cross-Walk: Integrating Behavioral Health and Primary Care
Updated/reviewed October 2018
  • Need: To address and treat substance abuse 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.
Maryland Faith Health Network
Updated/reviewed May 2018
  • Need: To coordinate formal and informal community-based caregivers for optimal patient experience.
  • Intervention: The Maryland Faith Health Network unites places of worship and healthcare systems in Maryland. This program aims to decrease the amount of potentially avoidable hospitalizations, improve a patient's overall wellness, and cut down on the cost of medical services.
  • Results: This model is currently running in 3 hospitals that serve both rural and urban residents in central Maryland. So far, 1,300 congregants from 70 congregations representing Christian, Jewish, and Muslim faiths have enrolled in the Network.

Other Project Examples

Beacon Health Accountable Care Organization
Updated/reviewed October 2020
  • Need: To implement coordinated healthcare to improve patient health and engagement and to reduce the overall cost of medical services in Maine.
  • Intervention: The Beacon Health network launched with a focus on patient-centered care to improve overall wellness and reduce ever-increasing healthcare costs.
  • Results: Through care coordination, Beacon Health is enhancing provider efficiency, improving patient engagement and healthcare quality, and lowering the overall cost of care.
funded by the Federal Office of Rural Health Policy Meadows Diabetes Education Program
Updated/reviewed September 2020
  • Need: To provide diabetes care and education services to those in rural southeast Georgia.
  • Intervention: Diabetes outreach screening, education, and clinical care services are provided to participants in Toombs, Tattnall, and Montgomery counties.
  • Results: Patients successfully learn self-management skills to lower their blood sugar, cholesterol, and blood pressure.
funded by the Federal Office of Rural Health Policy Miles for Smiles Mobile Dental Unit
Updated/reviewed September 2020
  • Need: Dental care access for children in low-income families living in a 7-county region of southwest Missouri.
  • Intervention: A mobile dental unit was created to expand dental care access.
  • Results: The Miles for Smiles mobile dental clinic provides comprehensive dental care to children throughout the 7-county region
Telehealth Collaborative Care
Updated/reviewed September 2020
  • Need: To increase access to specialty care for rural veterans living with HIV.
  • Intervention: The Telehealth Collaborative Care (TCC) study connects these patients with HIV specialists via clinical video telehealth or VA video connect and works to create shared care relationships with primary care teams in rural areas.
  • Results: TCC provides HIV specialty care access to rural veterans in a sustainable manner with infrastructure, mentorship, and capacity building.
funded by the Health Resources Services Administration West Virginia's Partners In Health Network Regional Collaborative Services
Updated/reviewed September 2020
  • Need: Coordinated approach to healthcare delivery in central and southern West Virginia.
  • Intervention: Creation of a nonprofit organization that focused on quality and collaboration.
  • Results: With an ability to provide services that meet the evolving needs of patients, providers, and communities, the organization provides unique services, such as a credentialing service and web-based data sharing care management tool.