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Resources by Topic: Service delivery models

Evaluation of the Next Generation Accountable Care Organization (NGACO) Model: Final Report
Sixth and final evaluation report on the Next Generation Accountable Care Organization (NGACO) Model. Summarizes findings from across all six performance years (2016-2021) and explores how participating entities responded to the model and how they did or did not achieve model goals. Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care; variations in model outcomes by organization characteristics; spending patterns of beneficiaries served by NGACOs; population health strategies and pathways to reduced spending; lessons learned; and more. The appendices include data on community and beneficiary characteristics, including rurality.
Additional links: Findings at a Glance, Technical Appendices
Date: 01/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Full Committee Oversight Hearing: "Rural Access: Is VA Meeting All Veterans Where They Live?"
The House Committee on Veterans' Affairs full committee oversight hearing discusses rural veteran's access to healthcare through the VA. Features a discussion of the VA's role as both a healthcare provider and a payer via its Community Care Program. Highlights technological challenges related to telehealth, such as lack of broadband connections and technological literacy of older veterans. Presents testimony from the VA, the Government Accountability Office, the Navajo Nation, and veteran advocacy groups, among others.
Additional links: Witnesses' Testimonies
Date: 01/2024
Type: Video/Multimedia
Sponsoring organization: House Committee on Veterans' Affairs
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Validation of Remote Anthropometric Measurements in a Rural Randomized Pediatric Clinical Trial in Primary Care Settings
Evaluates the effectiveness of remote assessment of height and weight for rural children, providing comparisons of remote and in-person measurements of 33 caregiver-child pairs. Provides measurement data, assesses measurement reliability, and identifies factors associated with measurement discrepancies. Describes the significance of findings in context of obesity treatment.
Author(s): E Zhang, Ann M. Davis, Elizabeth Yakes Jiminez, et al.
Citation: Scientific Reports, 14, 411
Date: 01/2024
Type: Document
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Telehealth Expansion, Internet Speed, and Primary Care Access Before and During COVID-19
Analyzes changes in primary care telehealth access among 172,387 Wisconsin Medicaid beneficiaries before and during the COVID-19 public health emergency. Covers the period June 2019 to December 2021, with data on telehealth visit count, telehealth share of visits, and PHE-induced decline in visits offset by telehealth. Assesses change in access over time by demographic characteristics, rural-urban dwelling, access to high speed internet, and health status.
Author(s): Alyssa Shell Tilhou, Arjun Jain, Thomas DeLeire
Citation: Jama Network Open, 7(1), e2347686
Date: 01/2024
Type: Document
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Telemedicine Use and Decrements to Type 2 Diabetes and Hypertension Care During the COVID-19 Pandemic
Examines type 2 diabetes and/or hypertension quality of care as associated with telemedicine use during the COVID-19 pre-pandemic (March 13, 2019 to December 31, 2019) and pandemic (March 13, 2020 to December 31, 2020) periods. Examines variables such as HbA1c monitoring and control, blood pressure monitoring and control, and telemedicine use. Presents data according to patient demographic information including age, sex, race/ethnicity, marital status, insurance type, health conditions, and metropolitan, micropolitan, small town, or rural residence.
Author(s): Hector P. Rodriguez, Elizabeth Ciemins, Karl Rubio, et al.
Citation: BMC Digital Health, 2, 2
Date: 01/2024
Type: Document
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Supportive Care Needs of Adults Living with a Peripherally Inserted Central Catheter (PICC) at Home: A Qualitative Content Analysis
Examines the challenges and supportive care needs of adults living at home with a peripherally inserted central catheter (PICC). Describes interview feedback from 15 participants focused on issues such as daily management of PICCs, physical and emotional impacts, and health literacy and supports. Includes information specific to adults living with PICCs in rural areas.
Author(s): Rebecca Sharp, Qunyan Xu, ‬‬‬‬‬‬‬‬‬‬‬Robyn Pumpa, et al.
Citation: BMC Nursing, 23, 4
Date: 01/2024
Type: Document
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Implementation of a Mobile Health Clinic Framework for Hepatitis C Virus Screening and Treatment: A Descriptive Study
Examines the effectiveness of utilizing mobile health clinics (MHC) for Hepatitis C Virus (HCV) treatment in underserved areas. Analyzes HCV screening and treatment rates of an MHC program initiated by Clemson Rural Health in South Carolina and discusses the impact of MHCs to provide healthcare access in rural and underserved areas.
Author(s): Lior Rennert, Kerry A. Howard, Caitlin M. Kickham, et al.
Citation: The Lancet Regional Health - Americas, 29
Date: 01/2024
Type: Document
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Bridging a Care Gap: Policy Opportunities for Improving Access to Home-Based Primary Care
Recording of a panel discussion on home-based primary care for rural older adults and policies that could address challenges with offering and accessing home-based primary care. Discusses telehealth, broadband, community infrastructure, service models, community health workers, and more. Transcript available in the video description.
Date: 12/2023
Type: Video/Multimedia
Sponsoring organization: Duke Margolis Institute for Health Policy
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Alternative Payment Models in the Quality Payment Program as of December 2023
A set of three tables that list brief information about Alternative Payment Models (APMs) that the Centers for Medicare and Medicaid Services (CMS) operates or has announced, as of December 2023. Identifies Advanced APMs, Merit Based Incentive Program (MIPs) APMs, and Other Payer Advanced APMs, which include Medicaid Other Payer Advanced APMs, Medicare Health Plan Payment Arrangements, and commercial payment arrangements.
Date: 12/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Breast Cancer Disparity and Outcomes in Underserved Women
Provides an overview of breast cancer disparities experienced by underserved and vulnerable women. Discusses racial and ethnic groups, gender minority population, and rural population, and highlights the significance of social determinants of health. Describes strategies to mitigate disparities and improve access, including education and engagement, community health workers, mobile mammography, and care coordination.
Author(s): B Bersu Ozcan, Başak E. Dogan, Ann R. Mootz, et al.
Citation: RadioGraphics, 44(1), 230090
Date: 12/2023
Type: Document
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