Rural Health
Resources by Topic: Service delivery models
Exploring Patient Care Navigation in the Medicare Program
Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Maternal and Child Health Services Title V Block Grant - Hawaii: FY 2024 Application/FY 2022 Annual Report
Describes Hawaii's maternal and child health programs, which include priorities related to family planning, food security, rates of child abuse and neglect, health screenings for children, wellness visits and vaccination, mental healthcare, telehealth access, and more. Discusses healthcare access issues for rural residents, activities by the Office of Primary Care and Rural Health, Medicaid provider shortages, and other rural-relevant issues.
Date: 09/2023
Sponsoring organization: Hawaii State Department of Health
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Describes Hawaii's maternal and child health programs, which include priorities related to family planning, food security, rates of child abuse and neglect, health screenings for children, wellness visits and vaccination, mental healthcare, telehealth access, and more. Discusses healthcare access issues for rural residents, activities by the Office of Primary Care and Rural Health, Medicaid provider shortages, and other rural-relevant issues.
Date: 09/2023
Sponsoring organization: Hawaii State Department of Health
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Effect of a Telephone-Based Lifestyle Intervention on Weight, Body Composition, and Metabolic Biomarkers in Rural Ohio: Results from a Randomized Pilot Study
Examines the effectiveness of a 15-week telephone counseling intervention encouraging healthy eating and physical activity among 27 rural Ohio adults with overweight or obesity. Provides data on participants' weight, body composition, fasting blood lipids, and inflammatory biomarkers after 15 weeks of intervention. Highlights findings related to weight and cholesterol management, and discusses rural health disparities and access barriers.
Author(s): Xiaochen Zhang, Victoria R. DeScenza, Zachary L. Chaplow, et al.
Citation: Nutrients, 15(18), 3998
Date: 09/2023
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Examines the effectiveness of a 15-week telephone counseling intervention encouraging healthy eating and physical activity among 27 rural Ohio adults with overweight or obesity. Provides data on participants' weight, body composition, fasting blood lipids, and inflammatory biomarkers after 15 weeks of intervention. Highlights findings related to weight and cholesterol management, and discusses rural health disparities and access barriers.
Author(s): Xiaochen Zhang, Victoria R. DeScenza, Zachary L. Chaplow, et al.
Citation: Nutrients, 15(18), 3998
Date: 09/2023
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Maternal, Infant, and Early Childhood Home Visiting Program in Rural America: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) in rural areas. Discusses the history of home visiting and the MIECHV program, Tribal MIECHV, program structure, eligible models, and promising approaches. Highlights three evidence-based home visiting models in Oregon that receive MIECHV funding. Offers policy recommendations related to improving MIECHV for rural families.
Date: 09/2023
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) in rural areas. Discusses the history of home visiting and the MIECHV program, Tribal MIECHV, program structure, eligible models, and promising approaches. Highlights three evidence-based home visiting models in Oregon that receive MIECHV funding. Offers policy recommendations related to improving MIECHV for rural families.
Date: 09/2023
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Mental Health Outcomes Among Patients Living in US Counties Lacking Broadband Access and Psychiatrists
Presents a study on mental health access for people who live in counties without psychiatrists and broadband coverage. Discusses the expansion of telehealth services for mental healthcare and consultation. Aims to evaluate mental health access in mostly rural counties with a workforce shortage and a lack of broadband access.
Author(s): Tarun Ramesh, Ryan K. McBain, Jonathan H. Cantor, et al.
Citation: JAMA Network Open, 6(9), e2333781
Date: 09/2023
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Presents a study on mental health access for people who live in counties without psychiatrists and broadband coverage. Discusses the expansion of telehealth services for mental healthcare and consultation. Aims to evaluate mental health access in mostly rural counties with a workforce shortage and a lack of broadband access.
Author(s): Tarun Ramesh, Ryan K. McBain, Jonathan H. Cantor, et al.
Citation: JAMA Network Open, 6(9), e2333781
Date: 09/2023
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Cancer Survivorship Challenges of Rural Older Adults: A Qualitative Study
Examines the perspectives of rural, older cancer survivors regarding their experiences, challenges, and related recommendations. Provides feedback from 27 former cancer patients regarding survivorship care plans, communication with their healthcare team, and transportation, financial, psychological, diet, and physical health challenges.
Author(s): Evelyn Arana-Chicas, Laura M. Hincapie Prisco, Saloni Sharma, et al.
Citation: BMC Cancer, 23(917)
Date: 09/2023
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Examines the perspectives of rural, older cancer survivors regarding their experiences, challenges, and related recommendations. Provides feedback from 27 former cancer patients regarding survivorship care plans, communication with their healthcare team, and transportation, financial, psychological, diet, and physical health challenges.
Author(s): Evelyn Arana-Chicas, Laura M. Hincapie Prisco, Saloni Sharma, et al.
Citation: BMC Cancer, 23(917)
Date: 09/2023
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Assessing the Impact of Medicaid Telehealth Policy Change on Equitable Access to Telehealth Services in North Carolina
Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Sponsoring organization: Milbank Memorial Fund
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Describes the evolution of North Carolina's Medicaid telehealth coverage and reimbursement policies in response to the COVID-19 pandemic. Discusses the impact of these policies on access to care. Compares data on telehealth claims by volume and as a percentage of total claims by race and rural-urban residence between March 2020 and December 2022.
Author(s): Shannon Dowler, Sam Thompson, Michelle Savuto, Jacqueline Marks-Smith, Jared Augenstein
Date: 09/2023
Sponsoring organization: Milbank Memorial Fund
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September 2023 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare Advantage benefits and coding, the Acute Care Hospital at Home program, and the shift of some surgical procedures from hospital outpatient departments to ambulatory surgical centers (ASCs). Includes rural references and considerations throughout.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Transcript from the Medicare Payment Advisory Commission's (MedPAC) September 2022 meeting. Covers Medicare Advantage benefits and coding, the Acute Care Hospital at Home program, and the shift of some surgical procedures from hospital outpatient departments to ambulatory surgical centers (ASCs). Includes rural references and considerations throughout.
Date: 09/2023
Sponsoring organization: Medicare Payment Advisory Commission
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