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Rural Health
Resources by Topic: Chronic disease management

Chronic Disease Management Systems (Registries) in Rural Health Care
Discusses the types of Chronic Disease Management Systems (CDMSs) used by a sample of 14 state organizations and 19 local rural clinics in Maine, Nebraska, New Mexico, South Carolina, Washington, and Wisconsin.
Author(s): Anne Skinner, Roslyn Fraser-Maginn, Keith J. Mueller
Date: 05/2006
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Barriers to Diabetes Self-management Education Programs in Underserved Rural Arkansas: Implications for Program Evaluation
Describes barriers faced during the implementation of DSME (Diabetes Self-Management Education) programs in medically underserved rural areas of Arkansas. Includes county maps showing the DSME program status and prevalence of diabetes.
Author(s): Appathurai Balamurugan, Mark Rivera, Leonard Jack, Kristen Allen, Sharon Morris
Citation: Preventing Chronic Disease, 3(1)
Date: 01/2006
Type: Document
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Elements of Successful Rural Diabetes Management Programs
Discusses innovations implemented by rural chronic disease management programs, with a focus on diabetes management as a proxy for all chronic diseases. Explored how local innovations overcame challenges of the rural setting in order to provide effective and efficient disease management.
Author(s): Roslyn Fraser, Anne M. Skinner, Keith J. Mueller
Date: 2006
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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A Field-Based Approach to Support Improved Diabetes Care in Rural States
Describes an effective approach that supported rural primary care practices in Montana and Wyoming to provide improved diabetes care.
Author(s): Elizabeth A. Johnson, Wanda L. Webb, Janet M. McDowall, et al.
Citation: Preventing Chronic Disease, 2(4)
Date: 10/2005
Type: Document
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Assessment of Barriers to the Delivery of Medicare Reimbursed Diabetes Self-Management Education in Rural Areas
Explores the barriers that rural practitioners face in providing Diabetes Self-Management Education (DSME) to Medicare beneficiaries.
Additional links: Fact Sheet
Author(s): M. Paige Powell, Saundra H. Glover, Janice C. Probst, Sarah B. Laditka
Date: 09/2004
Type: Document
Sponsoring organization: Rural and Minority Health Research Center (formerly the South Carolina Rural Health Research Center)
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Innovative Primary Care Case Management Programs Operating in Rural Communities: Case Studies of Three States
Discusses state programs that provide enhanced benefits to Medicaid beneficiaries such as enhanced primary care case management (PCCM). Includes examples from three states: Florida, North Carolina, and Oklahoma.
Additional links: Findings Brief, March 2003: Design of Enhanced Primary Care Case Management Programs Operating in Rural Communities: Lessons Learned from Three States
Author(s): Pam Silberman, Stephanie Poley, Rebecca Slifkin
Date: 01/2003
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Learning Network: Chronic Care Management Services
Provides general information about payable chronic care management service elements, practitioners able to bill for CCM services, patient eligibility, service codes, concurrent billing, and Medicare Physician Fee Schedule (PFS) billing requirements. Includes information on Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) billing for CCM services.
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model
Provides information on the Centers for Medicare & Medicaid Services (CMS) Innovation Center's ACO Realizing Equity, Access, and Community Health (ACO REACH) Model, which is intended to encourage healthcare coordination to improve care for people with Medicare, especially those from underserved communities.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Chronic Disease in Rural America Topic Guide
Provides resources and information on the impact of chronic disease in rural areas, as well as prevention and treatment strategies. Highlights specific chronic diseases, including heart disease and stroke, diabetes, chronic respiratory conditions, arthritis, and HIV/AIDS.
Type: Website
Sponsoring organization: Rural Health Information Hub
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Care Management Medicare Reimbursement Strategies for Rural Providers
Information for rural healthcare providers on Medicare billing codes for services to keep beneficiaries healthy and better coordinate services to support beneficiaries at home. Addresses Annual Wellness Visits, Chronic Care Management, Transitional Care Management, and Principal Care Management.
Type: Website
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, Rural Health Information Hub
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