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Rural Health
Resources by Topic: Service delivery models

Evaluation of the Vermont All-Payer Accountable Care Organization Model: Second Evaluation Report
Evaluates the first three performance years of the Vermont All-Payer Accountable Care Organization Model (VTAPM), which aims to assess whether scaling an Accountable Care Organization (ACO) across all payers in the state can reduce program expenditures while preserving or improving care quality. Discusses the implementation of the model, provider engagement, efforts to address population health goals; characteristics of participating hospitals, practitioners, and beneficiaries; and the model's impacts on Medicare spending, utilization, and quality of care. Describes changes to the model's design in response to the COVID-19 public health emergency and how COVID-19 and a cyberattack impacted healthcare utilization. Includes information on hospital and provider participation in rural areas and limited participation by Critical Access Hospitals.
Additional links: Findings at a Glance, Technical Appendices
Date: 12/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19
Provides an overview of federal and state-level changes of telehealth policy, regulations, and legal changes as of November 2022. Covers updates that impact Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and other facilities in rural areas.
Author(s): Jared Augenstein, Jacqueline D. Marks
Date: 11/2022
Type: Document
Sponsoring organization: Manatt on Health
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Active vs Traditional Methods of Recruiting Children for a Clinical Trial in Rural Primary Care Clinics: A Cluster-Randomized Clinical Trial
Discusses the effectiveness of active recruitment versus traditional recruitment for enrolling rural youth with overweight or obesity in a group behavioral telehealth intervention. Compares the use of direct engagement with pediatric patients at a clinic against the posting of flyers at a clinic and utilizing social media and press releases, with recruiting beginning in February 2020.
Author(s): Paul M. Darden II, Ann M. Davis, Jeannette Y. Lee, et al.
Citation: JAMA Network Open, 5(11), e2244040
Date: 11/2022
Type: Document
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Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2021
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Offers a summary of the findings from the prior annual reports on the CCBHC demonstration, a comparison of cost and quality in the first two demonstration years, and the results of impact analyses. This is the fifth annual report to Congress on the CCBHC demonstration.
Date: 11/2022
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Geospatial Analysis of Access to Health Care and Internet Services in the US
Study examining access to healthcare and internet services based on 2015-2019 American Community Survey data. Discusses implementations of findings for telemedicine expansion and the need for improved internet access to address rural-urban health disparities.
Author(s): Emefah C. Loccoh, Amanda Nguyen, Gaeun Kim, Haider J. Warraich
Citation: JAMA Network Open, 5(11), e2243792
Date: 11/2022
Type: Document
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A Scoping Review of Applications of the Consolidated Framework for Implementation Research (CFIR) to Telehealth Service Implementation Initiatives
A scoping review of the literature examining the application of the Consolidated Framework for Implementation Research (CFIR) relating to telehealth implementation initiatives. Searches 5 academic databases from 2010 to 2021 to review 64 peer-reviewed articles discussing CFIR and telehealth implementation initiatives. Includes articles that discuss telehealth implementation in rural and tribal areas.
Author(s): Pavani Rangachari, Swapandeep S. Mushiana, Krista Herbert
Citation: BMC Health Services Research, 22, 1450
Date: 11/2022
Type: Document
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Improving the Oral Health of Rural Veterans
Report explores rural veterans' access to oral healthcare. Compares the oral health of rural and urban veterans, highlights barriers to oral healthcare in rural areas, and makes recommendations for expanding access to oral healthcare.
Author(s): Annaliese Cothron, Hayam Megally, Don Clermont
Date: 11/2022
Type: Document
Sponsoring organization: CareQuest Institute for Oral Health
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 11/2022
Type: Document
Sponsoring organization: Rural Health Value
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State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency: 2022 Update
Examines state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 public health emergency (PHE). Describes the types of Medicaid services that were allowed to be delivered by telehealth and the types of telehealth modality covered before the PHE, in May 2020, and in January 2022. Outlines the status of state Medicaid telehealth flexibilities based on state executive orders and Medicaid agency guidance. Builds on a July 2021 analysis of state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 PHE.
Author(s): Jacquelyn Rudich, Ann B. Conmy, Rose C. Chum, et al
Date: 11/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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2022 Rural Health Care in Minnesota: Data Highlights
Chartbook providing an overview of rural healthcare in Minnesota. Presents data on demographics, the structure of the healthcare system in rural Minnesota, the healthcare workforce, changes in the availability of healthcare services, healthcare access utilization in rural Minnesota, and financing.
Additional links: Data Highlights
Date: 11/2022
Type: Document
Sponsoring organization: Minnesota Department of Health
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