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Rural Health
Resources by Topic: Care coordination

Grantee Sourcebook: Rural Health Network Planning Development Program, 2019
Detailed descriptions of 25 Rural Health Network Development Planning Program grant projects funded in fiscal year 2019. Reports on each grantee's network infrastructure development, plans for sustaining the network after the grant, and program activities addressing topics such as integrated service delivery, behavioral health, telehealth, and care coordination. Grantee profiles identify the geographic areas served, network partners, and primary contact person.
Date: 06/2020
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Sustainable Community Care Coordination Guide
Provides a framework for organizations to actively plan for the sustainability of established care coordination programs. Discusses identifying community organization partners, finding potential gaps in care coordination, and developing partnerships for ongoing success.
Date: 05/2020
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Making a Difference for Generations to Come: School-Based Oral Healthcare in Louisiana
Features a Louisiana Federally Qualified Health Center that offers primary care oral health assessment and fluoride varnishes in school-based health centers. Discusses the impact that access to childhood oral health services may have into adulthood.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 02/2020
Type: Document
Sponsoring organization: Rural Health Information Hub
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2020 Rural Advocacy Agenda
Outlines the American Hospital Association's federal policy priorities for rural hospitals in 2020. Offers recommendations in the areas of reimbursement, care coordination, maternal and obstetric care, behavioral health, regulations, health information technology, workforce, and prescription drug prices.
Date: 02/2020
Type: Document
Sponsoring organization: American Hospital Association
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The Rural Health Care Coordination Network Partnership Program: Critical Access Hospital Network of Eastern Washington
Describes and examines the impact of a care coordination program developed by the Critical Access Hospital Network (CAHN) of Eastern Washington. Provides care coordination services to Medicaid patients with at least two chronic conditions or one chronic condition and the risk of developing another. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018, with additional funding from the Empire Health Foundation.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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The Rural Health Care Coordination Network Partnership Program: Avera St. Mary's Completing the Circle Project
Describes and examines the impact of a care coordination program developed by Avera St. Mary's located in Pierre, South Dakota. Used a Patient Centered Medical Home (PCMH) model, providing services to patients with type 2 diabetes, one-third of whom were American Indian. The program's care team connected patients to resources and coordinated the patient's primary care providers, medications, specialists, other health care services, and a variety of social services. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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The Rural Health Care Coordination Network Partnership Program: Chautauqua County Health Hospital Network
Describes and examines the impact of a care coordination program developed by the Chautauqua County Health Network in New York. Offers well-coordinated preventive health services and links to community-based services to patients with diabetes, congestive heart failure (CHF), or chronic obstructive pulmonary disease (COPD) who need regular support but are not medically frail. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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The Rural Health Care Coordination Network Partnership Program: South East Rural Physicians Alliance
Describes and examines the impact of a care coordination program developed by the South East Rural Physicians Alliance-Independent Physician Association located in Nebraska. Program focuses on clinic-based care coordination for high-risk patients with diagnosed diabetes or congestive heart failure. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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The Rural Health Care Coordination Network Partnership Program: Worcester County Health Department
Describes and examines the impact of a care coordination program developed by the Worcester County Health Department located on the Eastern Shore of Maryland. Describes the program's care team of a registered nurse, masters-level social worker, and community health worker (CHW), working in collaboration with primary care providers. Serves patients with diabetes, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD), with a home visit and services tailored to the patient's unique needs. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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The Rural Health Care Coordination Network Partnership Program: Williamson Health and Wellness Center
Describes and examines the impact of a care coordination program developed by the Williamson Health and Wellness Center based in Williamson, West Virginia. Describes the program's use of care teams of community health workers, a registered nurse, and a nurse practitioner providing care coordination to patients with diabetes, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD). Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018, with additional private funding from a network of local philanthropies.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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