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Rural Health
Resources by Topic: Service delivery models

Evaluation of the Vermont All-Payer Accountable Care Organization Model: 2018-2022 - Fourth Evaluation Report
Evaluates the first five 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. Includes analyses of Medicare ACO subgroups and Medicaid spending, utilization, and quality of care trends. Outlines challenges and lessons learned.
Additional links: Findings at a Glance, Technical Appendices
Date: 06/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Health Subcommittee Hearing on Improving Value-Based Care for Patients and Providers
Recording of a June 26, 2024, House Committee on Ways and Means Subcommittee on Health hearing on the challenges and opportunities associated with delivering better health outcomes and Medicare savings through value-based care. Features testimony from Sarah Chouinard, Chief Medical Officer of Main Street Health, regarding value-based care delivery in rural areas.
Additional links: Sarah Chouinard, Main Street Health - Testimony
Date: 06/2024
Type: Video/Multimedia
Sponsoring organization: House Ways and Means Committee, Subcommittee on Health
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Provider-to-Provider Telemedicine for Sepsis Is Used Less Frequently in Communities with High Social Vulnerability
Examines the relationship between provider-to-provider emergency department-based telehealth consultation (tele-ED) and the prevalence of sepsis in counties with elevated social vulnerability index (SVI) scores. Analyzes 2016-2019 data from 1191 patients treated in rural, Midwestern EDs, with breakdowns according to patient, provider, hospital, and county characteristics. Discusses the relationship between SVI scores and tele-ED use.
Author(s): Kevin J. Tu, J. Priyanka Vakkalanka, Uche E. Okoro, et al.
Citation: Journal of Rural Health
Date: 06/2024
Type: Document
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Supporting Direct Acting Antiviral Medication Adherence and Treatment Completion in a Sample of Predominantly Rural Veterans with Hepatitis C and Substance Use Disorders
Explores strategies to improve direct acting antiviral (DAA) treatment among rural veterans with chronic hepatitis C virus (HCV) infection and substance use disorder (SUD). Analyzes a clinic-based intervention that utilizes motivational interviewing (MI) to improve medication adherence among 20 enrolled participants in a 12-week course.
Author(s): Mary Jane Burton, Andrew C. Voluse, Amee B. Patel
Citation: Addiction Science & Clinical Practice, 19, 51
Date: 06/2024
Type: Document
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Declines in Telemedicine Use Among Adults: United States, 2021 and 2022
Examines changes in telemedicine use by adults between 2021 and 2022. Analyzes data by various sociodemographic characteristics, Census Bureau region, and level of urbanization.
Author(s): Jacqueline W. Lucas, Xun Wang
Date: 06/2024
Type: Document
Sponsoring organization: National Center for Health Statistics
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Updated Analysis: Using Population-Based Outcome Measures to Assess the Impact of Telehealth Expansion on Medicare Beneficiaries' Access to Care and Quality of Care
Explores the association between telehealth use, quality of care, and access to care when both telehealth and in-person visits are available to fee-for-service (FFS) Medicare beneficiaries. Compares data from the second half of 2018 and 2019 to the second half of 2022 by the level of telehealth utilization in Hospital Service Areas (HSAs). Describes the effects of telehealth for urban and rural beneficiaries and differentiates between telehealth utilization for behavioral and non-behavioral health services. Updates a June 2023 report that analyzed data from 2021.
Author(s): Tanvi Rao, Angshuman Gooptu, Karin Johnson, Guido Cataife, Steven Susana-Castillo
Date: 06/2024
Type: Document
Sponsoring organizations: American Institutes for Research, Medicare Payment Advisory Commission
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The Evolution of Health System Planning and Implementation of Maternal Telehealth Services During the COVID-19 Pandemic
Analyzes the impact of telehealth to provide maternal healthcare services during the COVID-19 pandemic. Utilizes interview feedback from 15 health system leaders to discuss issues such as telehealth reimbursement, research, access, barriers, and integration. Includes commentary on telehealth use in rural areas.
Author(s): Monisa Aijaz, Burcu Bozkurt, Arrianna Marie Planey, et al.
Citation: Digital Health, 10
Date: 06/2024
Type: Document
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Facilitators and Barriers to Adopting or Expanding Medications for Opioid Use Disorder Provision in Rural Colorado Jails: a Qualitative Analysis
Reports findings of interviews with representatives of 7 rural Colorado jails on facilitators and barriers of medication for opioid use disorder (MOUD) adoption and expansion. Discusses factors including attitudes toward MOUD, collaborative partnerships, physical space, distance to services, provider availability, staff, and more.
Author(s): Heidi L. McNeely, Terri L. Schreiber, William L. Swann, Claudia R. Amura
Citation: Health and Justice, 12, 26
Date: 06/2024
Type: Document
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MedPAC Comment on CMS's Proposed Rule on the Hospital Inpatient PPS and the Long-term Care Hospital PPS for FY 2025
Comments on a May 2, 2024, Federal Register proposed rule revising the hospital inpatient and long-term care hospital (LTCH) prospective payment systems (PPS). Discusses proposals on rate-setting in both the inpatient prospective payment systems (IPPS) and LTCH PPS; the Transforming Episode Accountability Model (TEAM), including the definition of rural hospitals eligible to participate in a lower-risk track; new payments to small, independent hospitals that establish and maintain a 6-month buffer supply of essential medicines; updates to wage index values and policies; and updates to outlier reconciliation thresholds.
Date: 06/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Understanding Rural-Urban Differences in Veterans' Internet Access, Use and Patient Preferences for Telemedicine
Analyzes disparities among rural and urban veterans regarding telemedicine. Utilizes March 2022 survey data from 350 veterans about issues related to telemedicine use, including internet access, connection speeds, internet-connected devices, and use and perception of telemedicine.
Author(s): Amy M. J. O'Shea, Mikayla Gibson, James Merchant, et al.
Citation: Journal of Rural Health, 40(3), 438-445
Date: 06/2024
Type: Document
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