Rural Health
Resources by Topic: Service delivery models
Report to Congress: Social Risk Factors and Performance Under Medicare's Value-Based Purchasing Program
Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Uses Medicare data to examine the relationship between social risk factors and the performance of value-based purchasing programs. Discusses policy considerations that could help ensure value-based purchasing programs achieve their intended results, especially among high social risk populations. Categorizes rurality as a community risk factor and discusses whether beneficiaries with social risk factors such as rurality have worse outcomes due to their social risk profile, or because of the providers they see. Also provides rural-specific statistics and recommendations for using value-based purchasing to improve health outcomes among high social risk populations. Appendices summarize and provide additional details for each of the 9 programs evaluated. See the second report.
Additional links: Appendices
Date: 12/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs
Discusses the findings of a single-case, community-based participatory design study in a frontier community in northern Minnesota to determine the effectiveness of developing a community care team focused on collaboration and care coordination to improve patient outcomes and reduce emergency room use.
Author(s): Pat Conway, Heidi Favet, Laurie Hall, Jenny Uhrich, Jeanette Palcher, et al.
Citation: Journal of Health Care for the Poor and Underserved, 27(4A), 91–115
Date: 11/2016
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Discusses the findings of a single-case, community-based participatory design study in a frontier community in northern Minnesota to determine the effectiveness of developing a community care team focused on collaboration and care coordination to improve patient outcomes and reduce emergency room use.
Author(s): Pat Conway, Heidi Favet, Laurie Hall, Jenny Uhrich, Jeanette Palcher, et al.
Citation: Journal of Health Care for the Poor and Underserved, 27(4A), 91–115
Date: 11/2016
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Evaluation of Hospital-Setting HCIA Awards: Third Annual Report, Final
Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Third and final report evaluating 10 Health Care Innovation Awards Round One projects undertaken in a hospital inpatient or emergency department. Presents awardee-specific information on program impact and lessons learned. Includes projects that involved Critical Access Hospitals and other rural hospitals. Includes projects focused on improved care for sepsis and projects using remote electronic intensive care unit (eICU) services.
Additional links: Addendum, March 2017
Date: 11/2016
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Task Force on Ensuring Access in Vulnerable Communities
Report from a task force created by the American Hospital Association (AHA) charged with identifying access-related challenges facing vulnerable communities and examining ways in which hospitals can ensure access is maintained. Includes sections identifying characteristics of vulnerable rural and underserved communities, essential healthcare services to be maintained, emerging strategies, barriers to implementation, policy and advocacy issues, and more. Includes examples of emerging strategies and best practices from around the U.S.
Additional links: Executive Summary, Rural Chart Pack, Video
Date: 11/2016
Sponsoring organization: American Hospital Association
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Report from a task force created by the American Hospital Association (AHA) charged with identifying access-related challenges facing vulnerable communities and examining ways in which hospitals can ensure access is maintained. Includes sections identifying characteristics of vulnerable rural and underserved communities, essential healthcare services to be maintained, emerging strategies, barriers to implementation, policy and advocacy issues, and more. Includes examples of emerging strategies and best practices from around the U.S.
Additional links: Executive Summary, Rural Chart Pack, Video
Date: 11/2016
Sponsoring organization: American Hospital Association
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Freestanding Emergency Departments: An Alternative Model for Rural Communities
Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Sponsoring organization: Rural Health Information Hub
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Describes the freestanding emergency department (FSED) model as an option for rural communities that can no longer support inpatient services. Looks at both hospital-based and independent FSEDs, examines financial viability of the model, and features rural FSEDs in Illinois and Arizona.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 11/2016
Sponsoring organization: Rural Health Information Hub
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Implementation of the Federal Rural IMPACT Demonstration
Overview of the first year of the White House Rural Council and U.S. Department of Health & Human Services' demonstration project, focused on improving social determinants of health and designed to reduce poverty through coordinated services for children and parents. Discusses key findings and identifies possible lessons for policymakers and stakeholders. Includes appendix with profiles of the 10 demonstration sites.
Author(s): Alana Landey, Pam Winston, Pierre Joseph
Date: 11/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Overview of the first year of the White House Rural Council and U.S. Department of Health & Human Services' demonstration project, focused on improving social determinants of health and designed to reduce poverty through coordinated services for children and parents. Discusses key findings and identifies possible lessons for policymakers and stakeholders. Includes appendix with profiles of the 10 demonstration sites.
Author(s): Alana Landey, Pam Winston, Pierre Joseph
Date: 11/2016
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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"How Can We Talk about Patient-centered Care without Patients at the Table?" Lessons Learned from Patient Advisory Councils
Reports on a survey of patient advisory council (PAC) members associated with 8 primary care clinics and Federally Qualified Health Clinics (FQHCs), both rural and urban, in Northern California. Focuses on how PACs are developed, challenges faced, and the benefits of effective PACs.
Author(s): Anjana E. Sharma, Rachel Willard-Grace, Andrew Willis, et al.
Citation: Journal of the American Board of Family Medicine, 29(6), 775-784
Date: 11/2016
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Reports on a survey of patient advisory council (PAC) members associated with 8 primary care clinics and Federally Qualified Health Clinics (FQHCs), both rural and urban, in Northern California. Focuses on how PACs are developed, challenges faced, and the benefits of effective PACs.
Author(s): Anjana E. Sharma, Rachel Willard-Grace, Andrew Willis, et al.
Citation: Journal of the American Board of Family Medicine, 29(6), 775-784
Date: 11/2016
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Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health
Highlights ways substance use disorder treatment in rural and urban areas can be aligned with primary care, and provides recommendations and examples of how individuals, organizations, and communities can work together to reduce and prevent substance misuse.
Date: 11/2016
Sponsoring organization: U.S. Department of Health and Human Services
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Highlights ways substance use disorder treatment in rural and urban areas can be aligned with primary care, and provides recommendations and examples of how individuals, organizations, and communities can work together to reduce and prevent substance misuse.
Date: 11/2016
Sponsoring organization: U.S. Department of Health and Human Services
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Evaluation of Policy Options for Increasing the Availability of Primary Care Services in Rural Washington State
Analyzes policy options that the Washington state legislature has considered to address a perceived shortage of primary care physicians in rural Washington. Provides background on the rural primary care workforce within the state and projects the impacts each policy option would have through 2025. Policy options considered include: opening a new medical school at Washington State University (WSU), increasing the number of residency positions in the state, increasing loan repayment incentives to encourage rural practice, increasing Medicaid payment rates for rural physicians, and encouraging the use of alternative primary care models.
Additional links: Summary and Key Findings
Author(s): Mark W. Friedberg, Grant R. Martsolf, Chapin White, et al.
Date: 11/2016
Sponsoring organization: RAND Corporation
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Analyzes policy options that the Washington state legislature has considered to address a perceived shortage of primary care physicians in rural Washington. Provides background on the rural primary care workforce within the state and projects the impacts each policy option would have through 2025. Policy options considered include: opening a new medical school at Washington State University (WSU), increasing the number of residency positions in the state, increasing loan repayment incentives to encourage rural practice, increasing Medicaid payment rates for rural physicians, and encouraging the use of alternative primary care models.
Additional links: Summary and Key Findings
Author(s): Mark W. Friedberg, Grant R. Martsolf, Chapin White, et al.
Date: 11/2016
Sponsoring organization: RAND Corporation
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Emergency Department Telemedicine Is Used for More Severely Injured Rural Trauma Patients, but Does Not Decrease Transfer: A Cohort Study
Examines the use of telemedicine consultation in Critical Access Hospital (CAH) emergency departments in North Dakota. Focuses on whether telemedicine was used more frequently based on severity of injury or illness and whether telemedicine use decreased hospital transfers.
Author(s): Nicholas M. Mohr, Karisa K. Harland, Elizabeth A. Chrischilles, et al.
Citation: Academic Emergency Medicine, 24(2), 177-185
Date: 10/2016
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Examines the use of telemedicine consultation in Critical Access Hospital (CAH) emergency departments in North Dakota. Focuses on whether telemedicine was used more frequently based on severity of injury or illness and whether telemedicine use decreased hospital transfers.
Author(s): Nicholas M. Mohr, Karisa K. Harland, Elizabeth A. Chrischilles, et al.
Citation: Academic Emergency Medicine, 24(2), 177-185
Date: 10/2016
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