Rural Health
Resources by Topic: Care coordination
Case Studies From the 2017 Care Coordination Comparative Study
Provides an overview of four care coordination approaches being used in rural areas: care coach, clinical, community health worker, and school-based. Includes individual case studies of rural care coordination programs, with detailed information on target populations, technology used, partners, care team composition, and more.
Date: 05/2018
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Rural Health Innovations
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Provides an overview of four care coordination approaches being used in rural areas: care coach, clinical, community health worker, and school-based. Includes individual case studies of rural care coordination programs, with detailed information on target populations, technology used, partners, care team composition, and more.
Date: 05/2018
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Rural Health Innovations
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OSF HealthCare – Peoria, IL: Connecting Health Systems and Community-Based Organizations to Improve Outcomes
Features a faith-based, 13-hospital health care system serving Illinois and Michigan's Upper Peninsula. Describes OSF Center for Health - Streator, which will feature the first rural freestanding emergency department in Illinois. Discusses how OSF HealthCare is using a case management platform and working with community-based organizations to meet a wide range of patient needs.
Date: 05/2018
Type: Document
Sponsoring organization: American Hospital Association
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Features a faith-based, 13-hospital health care system serving Illinois and Michigan's Upper Peninsula. Describes OSF Center for Health - Streator, which will feature the first rural freestanding emergency department in Illinois. Discusses how OSF HealthCare is using a case management platform and working with community-based organizations to meet a wide range of patient needs.
Date: 05/2018
Type: Document
Sponsoring organization: American Hospital Association
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A Comparison of Collaborative Care Outcomes in Two Health Care Systems: VA Clinics and Federally Qualified Health Centers
Compares merged data from two different collaborative care trials: Telemedicine-Enhanced Antidepressant Management (TEAM) evaluating collaborative care for veterans with depression at a Veterans Affairs (VA) community-based outpatient clinics (CBOCs); and Outreach Using Telemedicine for Rural Enhanced Access in Community Health (OUTREACH) evaluating collaborative care for civilians with depression at Federally Qualified Health Clinics (FQHCs). Aim of study is to determine whether there are any significant differences in outcomes between the two population groups from each of the trials. Studies were conducted in the rural South.
Author(s): Kathleen M. Grubbs, John C. Fortney, Jeffrey Pyne, et al.
Citation: Psychiatric Services, 69(4), 431-437
Date: 04/2018
Type: Document
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Compares merged data from two different collaborative care trials: Telemedicine-Enhanced Antidepressant Management (TEAM) evaluating collaborative care for veterans with depression at a Veterans Affairs (VA) community-based outpatient clinics (CBOCs); and Outreach Using Telemedicine for Rural Enhanced Access in Community Health (OUTREACH) evaluating collaborative care for civilians with depression at Federally Qualified Health Clinics (FQHCs). Aim of study is to determine whether there are any significant differences in outcomes between the two population groups from each of the trials. Studies were conducted in the rural South.
Author(s): Kathleen M. Grubbs, John C. Fortney, Jeffrey Pyne, et al.
Citation: Psychiatric Services, 69(4), 431-437
Date: 04/2018
Type: Document
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An Interim Evaluation Report of the Innovative Projects Portfolio of the Medicare Flex Grant Program
Provides background on the Flex Program and the Integration of Innovative Health Care Models (Innovative Projects) program area. Evaluates the impact of the Innovative Projects program area across seven participating states, focusing on activities involving the transition to value-based care, telehealth, care coordination, quality improvement, and system delivery in rural communities. Final implementation results are described in Implementation and Early Results of the Flex Program's Innovative Models Program Area: Final Evaluation Report.
Author(s): Sara Kahn-Troster, John Gale, Anush Hansen, Andrew Coburn
Date: 01/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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Provides background on the Flex Program and the Integration of Innovative Health Care Models (Innovative Projects) program area. Evaluates the impact of the Innovative Projects program area across seven participating states, focusing on activities involving the transition to value-based care, telehealth, care coordination, quality improvement, and system delivery in rural communities. Final implementation results are described in Implementation and Early Results of the Flex Program's Innovative Models Program Area: Final Evaluation Report.
Author(s): Sara Kahn-Troster, John Gale, Anush Hansen, Andrew Coburn
Date: 01/2018
Type: Document
Sponsoring organization: Flex Monitoring Team
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The Impact of the Vermont Support and Services at Home Program on Healthcare Expenditures
The Support and Services at Home (SASH) program helps rural and urban program participants access healthcare and support services in order to maintain their health and age securely and safely in their homes. Report estimates the impact of the Vermont SASH program on Medicare expenditures.
Author(s): Amy Kandilov, Vince Keyes, Martijn van Hasselt, et al.
Citation: Cityscape, 20(2)
Date: 2018
Type: Document
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The Support and Services at Home (SASH) program helps rural and urban program participants access healthcare and support services in order to maintain their health and age securely and safely in their homes. Report estimates the impact of the Vermont SASH program on Medicare expenditures.
Author(s): Amy Kandilov, Vince Keyes, Martijn van Hasselt, et al.
Citation: Cityscape, 20(2)
Date: 2018
Type: Document
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Connected Care Toolkit: Chronic Care Management Resources for Health Care Professionals and Communities
A guide for healthcare professionals to support them in offering chronic care management (CCM) services. Provides links to CMS resources, including guides targeted to Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Also includes educational materials to help patients understand CCM services.
Date: 2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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A guide for healthcare professionals to support them in offering chronic care management (CCM) services. Provides links to CMS resources, including guides targeted to Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Also includes educational materials to help patients understand CCM services.
Date: 2018
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain
A guide to help primary care providers, practices, and healthcare systems manage patients who are on long-term opioid therapy. Provides an evidence-based prescribing guideline, quality improvement measures, and practice-level care coordination strategies. Appendix F provides examples of comprehensive management approaches, including discussion of telehealth approaches that could be used in rural communities.
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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A guide to help primary care providers, practices, and healthcare systems manage patients who are on long-term opioid therapy. Provides an evidence-based prescribing guideline, quality improvement measures, and practice-level care coordination strategies. Appendix F provides examples of comprehensive management approaches, including discussion of telehealth approaches that could be used in rural communities.
Date: 2018
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Maryland Rural Health Plan 2018
Details the current state of rural healthcare in Maryland, including areas of need, success of existing health plans, and corresponding recommendations. Presents county-level data, including the health priorities for each rural county.
Additional links: Maryland Rural Health Plan Website
Date: 2018
Type: Document
Sponsoring organization: Maryland Rural Health Association
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Details the current state of rural healthcare in Maryland, including areas of need, success of existing health plans, and corresponding recommendations. Presents county-level data, including the health priorities for each rural county.
Additional links: Maryland Rural Health Plan Website
Date: 2018
Type: Document
Sponsoring organization: Maryland Rural Health Association
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Meadville Medical Center: Care Coordination for Adults and Children
Describes the Meadville Medical Center Community Care Network (CCN), an interdisciplinary team of clinicians who focus on using care coordination to help patients manage chronic conditions and achieve their health and wellness goals. CCN's goal is to engage patients and encourage them to take ownership of their health, thereby reducing hospital readmissions, conserving resources, and improving the health of the population.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Describes the Meadville Medical Center Community Care Network (CCN), an interdisciplinary team of clinicians who focus on using care coordination to help patients manage chronic conditions and achieve their health and wellness goals. CCN's goal is to engage patients and encourage them to take ownership of their health, thereby reducing hospital readmissions, conserving resources, and improving the health of the population.
Date: 11/2017
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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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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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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