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Rural Healthcare Quality Resources

Selected recent or important resources focusing on Rural Healthcare Quality.

Improving Healthcare Value in Rural America
Identifies and explains the challenges facing rural communities as they work to improve healthcare value. Discusses the distinct differences between urban and rural value initiatives, highlights promising strategies for achieving rural value, and makes the case for using customized approaches rather than one-size-fits-all models.
Date: 10/2017
Type: Document
Sponsoring organization: Healthcare Value Hub
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2017 National Healthcare Quality and Disparities Report: Chartbook on Rural Health Care
Summarizes trends in healthcare quality and disparities for rural populations. Includes quality measures for access to healthcare, patient safety, person- and family-centered care, care coordination, affordability, healthy living, and effective treatment.
Author(s): Barbara Barton, Irim Azam
Date: 10/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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What is the Quality Payment Program?
Provides an overview of the Quality Payment Program (QPP) and its two associated payment tracks: the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (Advanced APMs). Describes how the QPP may affect rural practices, and includes links to additional resources.
Date: 09/2017
Type: Document
Sponsoring organization: National Organization of State Offices of Rural Health
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Advances in Patient Safety and Medical Liability
Explains the Agency for Healthcare Research and Quality's (AHRQ) Patient Safety and Medical Liability (PSML) Initiative, and shares contributions and findings from the PSML planning and demonstration grant projects. Includes two commentaries and nine papers organized around two main themes: improving communication and improving patient safety. Rural-specific considerations discussed throughout.
Author(s): James Battles, Irim Azam, Mary Grady, Kathryn Reback
Date: 08/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Consumer Assessment of Healthcare Providers and Systems Overview: Vendor Directory
Provides information about the benefits and challenges of implementing a HCAHPS survey process in small rural hospitals, specifically Critical Access Hospitals (CAHs). Includes a full directory of vendors currently authorized to perform HCAHPS data collection.
Date: 08/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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FY 2018 – 21: Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures for the grant cycle beginning in fiscal year 2018. Measures are broken down into four domains: patient safety, patient engagement, care transitions, and outpatient.
Date: 07/2017
Type: Document
Sponsoring organization: National Rural Health Resource Center
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2016 National Healthcare Quality and Disparities Report
Provides a comprehensive summary and data analysis of the quality of and access to healthcare received in the U.S. and discusses the disparities encountered by different racial and ethnic groups, and by geographic locations.
Additional links: Introduction and Methods
Date: 07/2017
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Catalog of Value-based Initiatives for Rural Providers
Summarizes rural-relevant, value-based programs currently or recently implemented by the U.S. Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the Center for Medicare and Medicaid Innovation (CMMI). Designed to help rural healthcare leaders identify HHS value-based programs that are suitable for rural participation. Catalog includes descriptions of each demonstration and provides direct links to the corresponding agency web page.
Date: 07/2017
Type: Document
Sponsoring organization: Rural Health Value
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CMS Hospital Quality Star Rating: For 762 Rural Hospitals, No Stars Is the Problem
Examines the characteristics of rural hospitals with and without quality star ratings, and explains how the current methodology disproportionately affects rural hospitals. Makes recommendations for improving the utility of the Hospital Quality Star Rating system, especially for the purpose of comparing quality among rural hospitals or between rural and urban hospitals.
Author(s): Kristie W. Thompson, Randy K. Randolph, Kristin L. Reiter, George H. Pink, G. Mark Holmes
Date: 06/2017
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Strategies for Superbugs: Antibiotic Stewardship for Rural Hospitals
Discusses the need for antibiotic stewardship (AS) and challenges rural hospitals face in implementing AS programs. Highlights efforts underway for a group of hospitals in Utah and at Critical Access Hospitals in Idaho and Utah.
Author(s): Kay Miller Temple
Location: Rural Monitor
Date: 03/2017
Type: Document
Sponsoring organization: Rural Health Information Hub
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Emergency Department Transfer Communication Brief
Provides background information and an overview of the Emergency Department Transfer Communication (EDTC) quality measure, which is being implemented by Critical Access Hospitals (CAHs) in the Medicare Beneficiary Quality Improvement Project (MBQIP). Includes tables and charts that illustrate reporting and improvement trends from Q1 2015 through Q3 2016.
Date: 02/2017
Type: Document
Sponsoring organization: Stratis Health
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Hospital Compare Quality Measure Results for CAHs, 2015
Examines Hospital Compare data for calendar year 2015 and summarizes reporting rates and performance among all U.S. Critical Access Hospitals (CAHs). Charts and graphs allow comparison of overall reporting rates and performance for specific quality measures, and state-by-state comparison of CAH reporting rates for inpatient and outpatient measures.
Additional links: State-Specific Reports
Author(s): Michelle Casey, Tami Swenson, Alex Evenson
Date: 02/2017
Type: Document
Sponsoring organization: Flex Monitoring Team
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Uniform Data Set (UDS) Measure Crosswalk to Other Quality Reporting Programs
Highlights the alignment between Uniform Data Set (UDS) measures and other quality reporting programs for calendar year 2017 reporting. Intended for use by rural health centers to help identify which UDS measures are being used by other programs such as CMS Accountable Care Organizations (ACOs) and the CMS Quality Payment Program (QPP).
Date: 01/2017
Type: Document
Sponsoring organization: Stratis Health
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Interpreting MBQIP Hospital Data Reports for Quality Improvement
Designed to help Critical Access Hospital (CAH) staff use Medicare Beneficiary Quality Improvement Project (MBQIP) Hospital Data Reports to support quality improvement efforts and improve patient care in their facility. Includes examples of how to interpret MBQIP reports, links to additional resources, and a glossary of key words and definitions.
Date: 01/2017
Type: Document
Sponsoring organization: Stratis Health
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Grantee Directory: Small Health Care Provider Quality Improvement Program, 2016-2019
Provides contact information and a brief overview of the 32 initiatives funded by the Federal Office of Rural Health Policy through the Small Health Care Provider Quality Improvement Grant Program in the 2016-2019 funding cycle. The program supports rural primary care providers implementing quality improvement activities, with the goal of promoting the development of an evidence-based culture and delivery of coordinated care in the primary care setting.
Date: 2017
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Quality Improvement Basics: A Collection of Helpful Resources for Rural Health Care Organizations
Designed for healthcare professionals who are new to the field, lists prominent organizations, learning resources, and programs related to healthcare quality improvement. Also includes as short list of recommended reading.
Date: 12/2016
Type: Document
Sponsoring organization: Stratis Health
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Medicare Accountable Care Organizations: Quality Performance by Geographic Categories
Using CMS 2014 and 2015 Medicare Accountable Care Organization (ACO) data, this brief examines the differences in ACO performance on 4 domains of quality measures: Patient/Caregiver Experience (PCE), Care Coordination/Patient Safety (CCP), Preventive Health (PH), and At-Risk Population (AtR) in rural and urban areas, and discusses the overall quality score of Medicare Shared Savings ACOs by geographic category.
Author(s): Xi Zhu, Keith Mueller, Thomas Vaughn, Fred Ullrich, A. Clinton MacKinney
Date: 09/2016
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Stroudwater Population Health
An 8-part video series designed to help rural healthcare organizations transition from payment for volume to payment for value, and advance population health strategies. Each part discusses an important strategy for achieving population health including quality and efficiency, network relationships and service rationalization, employer-sponsored health plans and fee-for-service payments, shared savings plans, and full risk payments and capitation.
Date: 06/2016
Type: Video/Multimedia
Sponsoring organization: Stroudwater Associates
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National Healthcare Quality and Disparities Chartbook on Care Coordination
A summary of trends in Care Coordination from the National Healthcare Quality and Disparities Report (QDR) for 2015. Includes data and statistics by metropolitan statistical area with a focus on groups with disparities in care coordination regarding hospital and emergency department visits, discharge, readmission, use of ED for chronic health care and potentially avoidable hospitalizations. Also highlights the use of electronic health records and electronic exchange and how that affects care coordination and quality.
Date: 06/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Compare Quality Measure Results for CAHs, Q2 2014 - Q1 2015
Discusses the reporting rates and performance of U.S. Critical Access Hospitals on CMS Hospital Compare quality measures. Includes data and statistics comparing inpatient and outpatient CAH participation, state rankings, process of care, median time to receiving care, and structural quality measures. Also includes links to state specific reports for 45 states.
Author(s): Michelle Casey, Tami Swenson, Alex Evenson
Date: 06/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
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Innovation in Rural Health Care: Contemporary Efforts to Transform into High Performance Systems
Provides themes and strategies focused on reducing the challenges related to healthcare innovation in rural areas based on discussions with rural and frontier innovators held September 2013 and July 2015. Includes a brief summary of programs and interventions developed by the rural and frontier organizations participating in these discussions.
Date: 05/2016
Type: Document
Sponsoring organization: Rural Health Value
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Quality Measures and Sociodemographic Risk Factors: The Rural Context
Demonstrates how rurality and sociodemographic variables may impact patient outcomes for rural populations using rural appropriate quality measures, and estimates the impact of adjusting for the rural environment on quality measurement.
Author(s): Carrie Henning-Smith, Katy B. Kozhimannil, Shailendra Prasad, Michelle Casey, Ira Moscovice
Date: 05/2016
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Flexibilities and Support for Small Practices
Describes flexibilities and supports for medical practices in rural or health professional shortage areas, in response to provisions of the proposed CMS Quality Payment Program as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Date: 05/2016
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Transforming Clinical Practice Initiative
Recording of an April 2016 webinar on the Transforming Clinical Practice Initiative (TCPI) model, featuring representatives from the Centers for Medicare & Medicaid Services and two Practice Transformation Networks.
Additional links: Presentation Slides
Date: 04/2016
Type: Video/Multimedia
Sponsoring organization: Federal Office of Rural Health Policy
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Emergency Department Visits for Children and Young Adults With Diabetes, 2012
Reports on diabetes-related emergency department visits, which may be related to undetected or poorly controlled diabetes, among children and young adults aged 0-29 years. Includes data by location of patient residence, for urban and rural locations.
Author(s): Aitalohi Amaize, Kamila B. Mistry
Date: 04/2016
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Jump Start Stewardship: Implementing Antimicrobial Stewardship in a Small, Rural Hospital
Presented in workbook format, provides small hospitals with guidance, tools, and resources for creating a successful antimicrobial stewardship program.
Author(s): Jamie Moran, Marisa D'Angeli, Kelly Kauber
Date: 03/2016
Type: Document
Sponsoring organization: Qualis Health
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Medicare Beneficiary Quality Improvement Project (MBQIP) Measures
Chart outlining the required and optional MBQIP measures for the grant cycle beginning in fiscal year 2015. Measures are broken down into four domains: patient safety, patient engagement, care transitions, and outpatient.
Date: 03/2016
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Reducing Potentially-Preventable Readmissions in Critical Access Hospitals
A policy brief describing evidence-based readmission prevention programs and strategies shown to be effective at reducing readmission rates for small rural hospitals, including Critical Access Hospitals (CAHs).
Author(s): Emma Distel, Michelle Casey, Shailendra Prasad
Date: 03/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
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Small Health Care Provider Quality Improvement Grant: A Cultural Shift in Quality for Providers
Features four grantees who undertook quality improvement programs supported by Federal Office of Rural Health Policy grants. Includes videos featuring the work of two of these grantees.
Author(s): Zachary Toliver
Location: Rural Monitor
Date: 02/2016
Type: Document
Sponsoring organization: Rural Health Information Hub
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Pilot Testing a Rural Health Clinic Quality Measurement Reporting System
Policy brief with results of a study focusing on assessing the feasibility and utility of the reporting system and quality measures for 61 participating Rural Health Clinics in 6 states. Includes statistics related to core measures and their perceived value as well as challenges or barriers to their use.
Author(s): John Gale, Anush Hansen, David Hartley, Andrew Coburn
Date: 02/2016
Type: Document
Sponsoring organization: Maine Rural Health Research Center
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Patients’ Experiences in CAHs: HCAHPS Results, Q2 2014 - Q1 2015
Results of the April 2014 - March 2015 Hospital Consumer Assessment of Healthcare Providers and Systems survey of reporting rates and performance in Critical Access Hospitals in the United States. Includes data broken down by state, national ranking, and links to state specific reports.
Author(s): Michelle Casey, Peiyin Hung, Alex Evenson
Date: 02/2016
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rural Hospital and Physician Participation in Private Sector Quality Initiatives
Results of a study to analyze 12 quality reporting and quality improvement programs being used by dominant insurers in Alabama, Kansas, Michigan, New Hampshire, South Carolina, and Utah, between 2011 and 2013.
Author(s): Amanda Diehl, Michelle Casey, Alex Evenson
Date: 10/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Hospital Value-based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of-Care Trends
Evaluates the initial effects of the Hospital Value-based Purchasing (HVBP) program on Medicare bonus payments and penalties, the quality of care provided, and selected quality improvement efforts during FY 2013-15. Analyzes data from safety net, small urban, and small rural hospitals.
Date: 10/2015
Type: Document
Sponsoring organization: Government Accountability Office
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A Cross-Sectional Study on Health Differences Between Rural and Non-Rural U.S. Counties Using the County Health Rankings
Examines the rural and urban differences in health and healthcare within the U.S. using data accessed from the 2013 County Health Rankings and Roadmaps. Vital health factors evaluated include mortality, morbidity, health behaviors, clinical care, social and economic factors, and the physical environment.
Author(s): Timothy J. Anderson, Daniel M. Saman, Martin S. Lipsky, M. Nawal Lutfiyya
Location: BMC Health Services Research, 15, 441
Date: 10/2015
Type: Document
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Post-discharge Rehabilitation Care Delivery for Rural Medicare Beneficiaries with Stroke
Discusses the factors associated with post-discharge rehabilitation care (PDRC) that influence the recovery and quality of life for rural stroke survivors receiving Medicare. Factors highlighted include distance to healthcare, type of rehabilitation, initial hospital admission, and patient race/ethnicity.
Additional links: Key Facts
Author(s): Jessica D. Bellinger, Zhimin Chen, Saundra Glover, et al.
Date: 09/2015
Type: Document
Sponsoring organization: South Carolina Rural Health Research Center
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Performance Measurement for Rural Low-Volume Providers
Identifies challenges to measuring healthcare performance among low-volume rural providers, and presents recommendations to meet these challenges. Primary focus is on finding appropriate quality measures for use within Centers for Medicare and Medicaid Services' (CMS) pay-for-performance programs, and encouraging rural participation in CMS quality improvement initiatives.
Date: 09/2015
Type: Document
Sponsoring organization: National Quality Forum
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2016 Physician Quality Reporting System (PQRS) Payment Adjustment
Fact sheet providing answers to frequently asked questions related to the Physician Quality Reporting System (PQRS). Includes an overview of the PQRS program, specifics concerning the 2016 negative payment adjustment, and the vision for the future of the program.
Date: 09/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Peer Coaches to Improve Diabetes Outcomes in Rural Alabama: A Cluster Randomized Trial
Discusses the results of a study comparing the effects of peer-coaching intervention that includes brief education vs. brief education alone on diabetes patients living in under resourced settings of rural Alabama.
Author(s): Monika M. Safford, Susan Andreae, Andrea L. Cherrington, et al.
Location: Annals of Family Medicine, 13(Suppl 1), 18–S26.
Date: 08/2015
Type: Document
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Leading Change: Best Practices in Technical Assistance for Rural and Frontier Health-Care in an Era of Transformation
Provides resources, tools, and proven practices to augment technical assistance and support the development and implementation of services provided by State Offices of Rural Health (SORH), nonprofit organizations, and government agencies when working with rural and frontier health service organizations (HSOs).
Date: 08/2015
Type: Document
Sponsoring organization: National Center for Frontier Communities
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Healthcare Costs and Outcomes for Pediatric Inpatients with Bronchiolitis: Comparison of Urban Versus Rural Hospitals
Compares quality and costs between rural and urban settings for low severity pediatric bronchiolitis admissions.
Author(s): Benson Hsu, Benjamin Meyer, Saquib Lakhani
Location: Rural and Remote Health, 15, 3380
Date: 06/2015
Type: Document
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2015 National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Report
Evaluates the effects of measures used in the Centers for Medicare & Medicaid Services (CMS) quality reporting programs on achieving high quality, affordable healthcare. Provides statistics concerning participation and performance within Medicare quality reporting programs, including statistics specific to healthcare facilities located in rural areas.
Date: 03/2015
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Comprehensive Quality Improvement in Rural Health Care
Policy paper addresses comprehensive quality improvement for rural healthcare by incorporating and tailoring strategies from the National Quality Strategy (NQS) aims of better care, healthy people/communities and affordable care to better suit rural healthcare. Includes four broad steps to help guide rural facilities through the quality improvement process.
Author(s): Kevin Driesen, Gretchen Holmes, Mary Smith
Date: 02/2015
Type: Document
Sponsoring organization: National Rural Health Association
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Review Strategies to Recruit and Retain Rural Patient Participating Self-Management Behavioral Trials
Discusses effective methods to encourage rural patients with cardiovascular disease to participate in self-management behavioral intervention trials designed to improve health outcomes and reduce healthcare costs.
Author(s): Lufei Young, Susan Barnason, Van Do
Location: Online Journal of Rural Research & Policy, 10(2)
Date: 2015
Type: Document
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Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study
Results of a survey in which 172 physicians identified which measures were most useful in reporting and improving care in their daily practice.
Author(s): Lyle J. Fagnan, LeAnn Michaels, Katrina Ramsey, et al.
Location: Journal of the American Board of Family Medicine, 28(5), 595-604
Date: 2015
Type: Document
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Grantee Directory: Small Health Care Provider Quality Improvement Grant Program, 2013-2016
Provides contact information and a brief overview of the 29 initiatives funded by the Federal Office of Rural Health Policy through the Small Health Care Provider Quality Improvement Grant Program in the 2013-2016 funding cycle. The program supports rural primary care providers implementing quality improvement activities, with the goal of promoting the development of an evidence-based culture and delivery of coordinated care in the primary care setting.
Date: 12/2014
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Utilization of Intensive Care Services, 2011
Provides data on utilization of intensive care services across 29 states. Table 3 provides information on ICU utilization by hospital characteristics, including metropolitan or non-metropolitan location, and hospital designation (Critical Access or teaching).
Author(s): Marguerite L. Barrett, Mark W. Smith, Anne Elixhauser, Leah S. Honigman, Jesse M. Pines
Date: 12/2014
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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The ACA and Beyond: Public Policy and Marketplace Changes Affecting the Future of Rural Health
Slides from a presentation by Keith Mueller of the Rural Policy Research Institute discussing the changing landscape of rural healthcare. Highlights how changes initiated by the Affordable Care Act (ACA), particularly in the areas of insurance coverage, quality requirements, and payment and system reform, have led to paradigm shifts in rural healthcare service delivery.
Author(s): Keith Mueller
Date: 11/2014
Type: Presentation Slides
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Geographic Variation in Potentially Preventable Hospitalizations for Acute and Chronic Conditions, 2005-2011
Examines potentially preventable hospitalizations for adults from 2005 to 2011. Includes data for acute and chronic conditions by location of patient residence for large and small metropolitan, micropolitan, and remote rural areas.
Author(s): Celeste M. Torio , Roxanne M. Andrews
Date: 09/2014
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Controlling Hypertension: Focusing on "Why" Makes "How" a Lot Easier
Provides an overview of a quality improvement project targeted toward improving the outcomes of patients with hypertension that was implemented within a family medicine group of five separate small rural practices.
Author(s): Jennifer L. Brull
Location: Family Practice Management, 21(5), 23-27
Date: 09/2014
Type: Document
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National Healthcare Disparities Report, 2013
Summarizes the progress and opportunities regarding healthcare quality and access among various racial, ethnic, and income groups, and other priority populations in rural and urban areas. Includes rural specific discussion on access to and quality of healthcare, chronic diseases, exchange of electronic patient information, language barriers, behavioral health, and scarcity of mental health service providers.
Date: 05/2014
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Project ECHO: Bridging the Gap in Health Care for Rural and Underserved Communities
Discusses the Project ECHO model and how it allows physicians, nurse practitioners, and other clinicians to jointly manage complex illness and promotes the use of best practices in care, while enabling patients to receive treatment in their rural communities.
Date: 04/2014
Type: Document
Sponsoring organization: Robert Wood Johnson Foundation
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The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A Second Look
Addresses the impact of the Patient Protection and Affordable Care Act on rural communities including the issues of health insurance coverage, Medicare and Medicaid payment, quality and delivery system reform, public health, healthcare workforce, and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, et al.
Date: 04/2014
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Characteristics of Adverse Drug Events Originating During the Hospital Stay, 2011
Provides hospital inpatient data on the four most common adverse drug events (ADEs). Table 1 and Figure 4 list data on ADEs for rural compared to urban hospitals.
Author(s): Audrey J. Weiss, Anne Elixhauser
Date: 10/2013
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Emergency Department Super Utilizer Programs: Rural Health Systems Analysis and Technical Assistance Project
White paper describing a super utilizer program design, implementation, operation, and assessment for rural hospitals to improving participant health, reducing ED visits, and decrease hospital charges. “Super utilizer” patients often present to the emergency department (ED) with chronic and low acuity health concerns that are inappropriately addressed in a ED setting designed to care for acute, episodic, and emergent health conditions.
Author(s): Christopher D. Stamy, A. Clinton MacKinney
Date: 10/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Critical Access Hospital Year 8 Hospital Compare Participation and Quality Measure Results
Examines 2011 participation and quality measure results for Critical Access Hospitals (CAHs) in the Centers for Medicare and Medicaid Services (CMS) Hospital Compare public reporting database for hospital quality measures.
Additional links: Policy Brief
Author(s): Michelle Casey, Peiyin Hung, Ira Moscovice
Date: 09/2013
Type: Document
Sponsoring organization: Flex Monitoring Team
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Health Care in the Two Americas: Findings from the Scorecard on State Health System Performance for Low-Income Populations, 2013
Identifies opportunities for states to improve their health systems for economically disadvantaged populations in both rural and urban areas and provides state benchmarks of achievement.
Author(s): Cathy Schoen, David Radley, Pamela Riley, et al.
Date: 09/2013
Type: Document
Sponsoring organization: Commonwealth Fund
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Findings and Lessons from the Improving Quality Through Clinician Use of Health IT Grant Initiative
Details the findings of 24 Agency for Healthcare Research and Quality (AHRQ) funded projects, both in rural and urban settings, examining how health IT applications can assist healthcare providers in providing evidence based care. Discusses multiple factors related to improving quality through health IT including supporting clinical workflow and coordinating care.
Date: 09/2013
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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2013 National Rural Emergency Department Study: Establishing Rural Relevant Benchmarks
Evaluates performance measures in rural hospitals' emergency departments in comparison to their urban counterparts during the 2012 calendar year.
Date: 07/2013
Type: Document
Sponsoring organization: iVantage Health Analytics
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Obstetric Services and Quality Among Critical Access, Rural, and Urban Hospitals in Nine States
Compares the characteristics and quality of obstetric care in Critical Access Hospitals, other rural hospitals, and their urban counterparts.
Author(s): Katy Kozhimannil, Peiyin Hung, Maeve McClellan, et al.
Date: 06/2013
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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An Overview of Lean: A Guide for the Small Rural Hospital Improvement Grant Program
Explains the key Lean concepts as they relate to rural healthcare delivery, and outlines the necessary steps that will help rural healthcare facilities reduce waste, improve productivity, and provide better patient care.
Date: 04/2013
Type: Document
Sponsoring organization: National Rural Health Resource Center
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The Colorado Beacon Consortium: Strengthening the Capacity for Health Care Delivery Transformation in Rural Communities
Describes how physicians, hospitals, and other care providers in seven predominantly rural counties managed to build the capacity needed to exchange health data and transform clinical care.
Author(s): D. McCarthy, A. Cohen
Date: 04/2013
Type: Document
Sponsoring organization: Commonwealth Fund
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Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Guide: Using HCAHPS to Drive Patient and Employee Satisfaction
Describes the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and data collection process. Explains how rural providers can use the survey findings to improve hospital operations, patient outcomes, and quality scores. Includes case studies of two hospitals that used HCAHPS data to successfully drive patient and employee satisfaction.
Date: 03/2013
Type: Document
Sponsoring organization: National Rural Health Resource Center
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Emergency Transfers of the Elderly from Nursing Facilities to Critical Access Hospitals: Opportunities for Improving Patient Safety and Quality
Study which provides tools for improved communication between patients, nursing facilities, and hospitals during transfer of care. Includes recommendations for the role of state Flex Programs in this process.
Author(s): Karen B. Pearson, Andrew F. Coburn
Date: 01/2013
Type: Document
Sponsoring organization: Flex Monitoring Team
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Hospitals on the Path to Accountable Care: Highlights from a 2011 National Survey of Hospital Readiness to Participate in an Accountable Care Organization
Reports on the results from a survey of health care providers across the country, including rural, that assesses hospitals’ readiness to participate in ACOs.
Author(s): Anne-Marie J. Audet, Kevin Kenward, Shreya Patel, Maulik S. Joshi
Date: 08/2012
Type: Document
Sponsoring organization: Commonwealth Fund
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Evidence-Based Surgical Care Quality Improvement Programs and Strategies for Critical Access Hospitals
Focuses on evidence-based surgical care QI programs and strategies applicable to inpatient and outpatient surgeries in CAHs. One in a series of policy briefs identifying and assessing evidence-based patient safety and quality improvement interventions for use by state Flex Programs and Critical Access Hospitals (CAHs).
Author(s): Jill Klingner, Michelle Casey, Shailendra Prasad, Walter Gregg, Ira Moscovice
Date: 08/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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Evidence-Based Acute Myocardial Infarction (AMI) Quality Improvement Programs/Strategies for Critical Access Hospitals
This policy brief focuses on evidence-based AMI Quality Improvement (QI) programs and strategies that are applicable to CAHs.
Author(s): Shailendra Prasad, Jill Klingner, Michelle Casey, Walter Gregg, Ira Moscovice
Date: 08/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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Public Reporting of Quality by Critical Access Hospitals: The Key Issues
Policy paper reviews the progress made in rural hospital public reporting of quality from 2005-2012 with an increased emphasis and use of data for measuring performance and maintaining payment. Describes the current challenges Critical Access Hospitals (CAH) face when participating in quality reporting.
Date: 01/2012
Type: Document
Sponsoring organization: National Rural Health Association
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Quality Incentives for Federally Qualified Health Centers, Rural Health Clinics and Free Clinics: A Report to Congress
Discusses current initiatives and incentives that apply to primary care clinics regarding quality of care and the use of health information technology.
Date: 01/2012
Type: Document
Sponsoring organization: George Washington University Department of Health Policy and Management
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Relevant Quality Measures for Critical Access Hospitals
Policy brief describes quality measures relevant to Critical Access Hospitals (CAHs) and identifies policy implications.
Author(s): Michelle Casey, Ira Moscovice, Jill Klingner, Shailendra Prasad
Date: 01/2012
Type: Document
Sponsoring organization: Flex Monitoring Team
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TeamSTEPPS: Better Hospital Teamwork Increases Patient Safety
Discusses the TeamSTEPPS system, which improves patient safety by fostering better communication and teamwork among health care professionals.
Author(s): Candi Helseth
Location: Rural Monitor, 2011(Fall)
Date: 11/2011
Type: Document
Sponsoring organization: Rural Health Information Hub
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Electronic Consultations Between Primary and Specialty Care Clinicians: Early Insights
Explores the use of electronic consultation (e-consultation) for enabling primary care clinicians and specialists to communicate about patients at times that are mutually convenient and in rural areas where there is a shortage of specialists.
Author(s): Kathryn Horner, Ed Wagner, Jim Tufano,
Date: 10/2011
Type: Document
Sponsoring organization: Commonwealth Fund
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Will Bundling Work in Rural America? Analysis of the Feasibility and Consequences of Bundled Payments for Rural Health Providers and Patients (Policy Brief)
Assesses how bundled payments may affect both healthcare quality and access among rural providers, and explains the financial and operational challenges associated with implementing bundled payments in low-volume providers such as Critical Access Hospitals (CAHs).
Author(s): Robert Town, Walter Gregg, Ira Moscovice, Shailendra Prasad, Jill Klingner
Date: 09/2011
Type: Document
Sponsoring organization: Upper Midwest Rural Health Research Center
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Modernizing Rural Health Care: Coverage, Quality and Innovation
Examines health needs of rural populations, and how well the health care system addresses them. Presents new data on rural care quality; on the views of people living in rural areas; rural networks; rural telemedicine; and what their physicians see as the major challenges to overcome. This is the sixth in a series of working papers by UnitedHealth Group focusing on health reform topics.
Date: 07/2011
Type: Document
Sponsoring organization: UnitedHealth Center for Health Reform and Modernization
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Advancing Health in Rural America: Maximizing Nursing’s Impact
Provides a link between the evidence-based nursing solutions in the Future of Nursing: Leading Change, Advancing Health report and the health care challenges facing rural America. Outlines the challenges of providing access to quality, affordable care in rural areas, followed by examples of initial progress in additional support to key programs.
Author(s): Mary S. Gorski
Date: 06/2011
Type: Document
Sponsoring organization: AARP Public Policy Institute
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A Meaningful User of an Electronic Health Record System Describes Its Clinical and Financial Benefits
Summary of a rural family practice doctor's experience to be one of the first certified as a meaningful user of health information technology.
Author(s): Sarah Klein
Location: Quality Matters
Date: 06/2011
Type: Document
Sponsoring organization: Commonwealth Fund
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The Patient Protection and Affordable Care Act of 2010: Impacts on Rural People, Places, and Providers: A First Look
Summarizes six issue areas of the Affordable Care Act (ACA) and discusses implications for access to services and improving the health status of rural residents. These issue areas are: health insurance coverage; Medicare and Medicaid payment; quality, financing, and delivery system reform; public health; healthcare workforce; and long-term care.
Author(s): Andrew F. Coburn, Jennifer P. Lundblad, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller
Date: 09/2010
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Patient Assessments and Quality of Care in Rural Hospitals
Analyzes the relationships between rural patients' perspectives of hospital quality of care and key hospital characteristics that may influence patients' experiences of hospital care.
Additional links: Policy Brief
Author(s): Michelle Casey, Gestur Davidson
Date: 06/2010
Type: Document
Sponsoring organization: Upper Midwest Rural Health Research Center
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Quality of Care for Acute Myocardial Infarction: Are the Gaps Between Rural and Urban Hospitals Closing?
Compared the quality of care provided by urban and rural hospitals for patients with acute myocardial infarction.
Additional links: Policy Brief
Author(s): Laura-Mae Baldwin, Leighton Chan, C. Holly A. Andrilla, Edwin Huff, L. Gary Hart
Date: 03/2010
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Models For Quality Improvement In Critical Access Hospitals: The Role Of State Flex Programs
Examines the range of multi-Critical Access Hospital (CAH) quality improvement and performance measurement reporting (QI) initiatives supported by the Medicare Rural Hospital Flexibility Program in nine states; assessed the role of State Flex Programs in developing and supporting these initiatives; and explored their impact on the QI programs of CAHs.
Author(s): Coburn, Gale, Race, Richards, Hansen
Date: 03/2010
Type: Document
Sponsoring organization: Flex Monitoring Team
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Outcomes of Community Health Worker Interventions
Results of a systematic review on the characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. Includes references to rural.
Date: 06/2009
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Quality Through Collaboration: The Future of Rural Health Care
Examines healthcare quality in rural America and offers a strategy to address the quality challenges in rural communities. Includes key findings on rural healthcare quality and patient safety, as well as recommendations.
Date: 2005
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Crossing the Quality Chasm: A New Health System for the 21st Century
Examines the delivery system of healthcare in rural America and recommends a fundamental redesign to ensure high quality, safe, and effective healthcare provision for all Americans. (Free, registration required.)
Author(s): Committee on the Quality of Health Care in America
Date: 03/2001
Type: Document
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Stratis Health 2017 MIPS Estimator
Web-based tool allows providers to calculate a composite Merit-based Incentive Payment System (MIPS) score. Presents data submission methods to produce the highest base-line score and enables workflow adjustments to improve patient outcomes.
Type: Tool
Sponsoring organization: Stratis Health
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Hospice Compare
Provides information on quality of care provided by Medicare-certified hospice agencies, using data related to patient preferences and effectiveness in managing pain and treating symptoms.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Support and Available Options for Small, Underserved, and Rural Practices
Section of the Quality Payment Program (QPP) website, enabling practices with 15 or fewer clinicians to receive free, customized technical assistance, including help choosing and reporting on quality measures, guidance with strategic planning, and support optimizing health information technology.
Type: Website
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Physician Compare
Provides consumers with information on physicians that accept Medicare patients. Includes practice location, physician specialties, hospital affiliation, and participation in selected Centers for Medicare and Medicaid Services quality improvement programs.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Rural Healthy People 2020
Outlines the strategic plan for completing Rural Healthy People (RHP) 2020, names the top priority areas to be addressed, and describes the next steps toward its development. RHP 2020 will aim to identify rural health priorities, support rural health leaders and researchers, and promote effective rural health programs.
Type: Website
Sponsoring organization: Southwest Rural Health Research Center
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Residents of Rural Areas Quality Measures Compared to Achievable Benchmarks
Compares National Healthcare Quality Report quality measures for rural areas to achievable benchmarks. Identifies measures where rural areas achieved or exceeded the benchmark, were close to the benchmark, and far from the benchmark. Includes links to the data.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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NHQR/NHDR Data Query
Interactive tool for accessing national and state data from the National Healthcare Quality and Disparities Reports, including trends. To view national rural data, select "Priority Populations" under subject area and "Residents of Rural Areas" under topic, then under "by category" select "Geographic location" to display.
Type: Database
Sponsoring organization: Agency for Healthcare Research and Quality
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Rural Care Coordination Toolkit
Designed to help identify and implement a rural care coordination program and provide supporting resources and best practices. The toolkit, developed in collaboration with the NORC Walsh Center for Rural Health Analysis, is made up of several modules each concentrating on different aspects of care coordination programs.
Type: Website
Sponsoring organization: Rural Health Information Hub
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CMS Innovation Center
Supports the development, testing and sharing of innovative healthcare payment and service delivery models. Includes data, reports, webinars and forums for sharing knowledge among healthcare innovators, data researchers and policy analysts.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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CMS Quality Initiatives - General Information
Lists the various CMS quality initiatives with narration and links.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Dartmouth Atlas of Health Care
Provides access to Medicare data on enrollee demographics, reimbursement, utilization and quality. Map-based interface with profiles by hospital and region. Also includes national maps and data by topic.
Type: Website
Sponsoring organization: The Dartmouth Institute for Health Policy and Clinical Practice
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AHA Community Connections
Provides access to case studies spotlighting hospitals and health systems (some are in rural areas) that have successfully collaborated with local community organizations to promote care coordination, wellness, and prevention. Website also includes tools and resources to help healthcare facilities be accountable and transparent to their communities and deliver quality care.
Type: Website
Sponsoring organization: American Hospital Association
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County Health Rankings and Roadmaps
County-by-county information on health outcomes and health factors. Each county is ranked within its state. Includes data related to length of life, quality of life, clinical care, health behaviors, social and economic factors that impact health, and the physical environment. State Health Gaps reports explore differences in health among counties for each state. Also includes examples of how the rankings have been used and of effective programs and policies to improve health.
Type: Website
Sponsoring organization: Robert Wood Johnson Foundation
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AHRQ Quality Indicators Toolkit for Hospitals
Helps hospitals understand the Quality Indicators (QIs) from the Agency for Healthcare Research and Quality (AHRQ), and support the use of them to successfully improve quality and patient safety in hospitals.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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QualityNet
CMS-approved website for secure communications and healthcare quality data exchange between: quality improvement organizations (QIOs), hospitals, physician offices, nursing homes, end stage renal disease (ESRD) networks and facilities, and data vendors.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Medicare Beneficiary Quality Improvement Project (MBQIP)
Series of resources designed to help Critical Access Hospitals understand and execute the MBQIP measures. Includes tools and strategies rural hospitals can use to report, analyze, and translate their data into actual quality improvement.
Type: Website
Sponsoring organization: National Rural Health Resource Center
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PubMed Search: Health Care Quality and Rural Health Services
Searches PubMed's collection of journal article citations on the topic of rural health care quality.
Type: Literature Search
Sponsoring organization: National Library of Medicine
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National Practitioner Data Bank - Healthcare Integrity and Protection Data Bank
An alert or flagging system intended to facilitate a comprehensive review of health care practitioners’ professional credentials.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Health System Data Center
An interactive U.S. map providing access to state and hospital referral region data and comparative rankings on healthcare access, quality, cost, and outcomes. Provides access to the Commonwealth Fund's Scorecard on State Health System Performance.
Type: Website
Sponsoring organization: Commonwealth Fund
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WhyNotTheBest.org
Tracks performance on various measures of health care quality. Enables organizations to compare their performance against that of their peers in both rural and urban locations.
Type: Website
Sponsoring organization: Commonwealth Fund
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TeamSTEPPS Curriculum Tools and Materials
An evidence-based teamwork system aimed at optimizing patient outcomes by improving teamwork skills among healthcare professionals. Includes a comprehensive set of ready-to-use materials and training curricula necessary to successfully integrate teamwork principles into your healthcare system.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Survey on Patient Safety Culture
Hospital staff survey designed to help hospitals assess the culture of safety in their institutions. Includes survey form, items, components, user's guide, and a comparative database.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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AHA Quality and Patient Safety
A resource of the AHA to help hospitals accelerate their quality and performance improvement processes. Features tools, articles and news.
Type: Website
Sponsoring organization: American Hospital Association
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AHRQ Health Care Innovations Exchange
Provides access to innovations, tools, learning opportunities, and networking opportunities, all designed to speed the implementation of new and better ways of delivering health care.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Physician Quality Reporting System
Consists of a voluntary physician quality reporting program established by CMS providing financial incentive for eligible professionals.
Type: Website
Sponsoring organization: Centers for Medicare and Medicaid Services
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Agency for Healthcare Research and Quality (AHRQ) National Healthcare Quality and Disparities Reports: State Snapshots
Provides state-specific health care quality and disparities information, including strengths, weaknesses, and opportunities for improvement. Information is based on the National Healthcare Quality Report and National Healthcare Disparities Report and is updated annually.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Consumer Assessment of Healthcare Providers and Systems (CAHPS)
A public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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PSNet: Patient Safety Network
A continuously updated, annotated, and selected collection of patient safety news, literature, tools, and resources. Includes resources addressing patient safety in rural settings.
Type: Website
Sponsoring organization: Agency for Healthcare Research and Quality
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Hospital Compare
Provides information on the quality of care provided by Medicare-certified hospitals care for patients with specific medical conditions applying specific measures on patient experiences, timely and effective care, surgical procedures, readmissions & mortality rates, and payment and value of care.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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HCUPnet
Online tool for accessing Healthcare Cost and Utilization Project data. Provides access to health statistics and information on hospital stays at the national, regional, state, and county level. Includes data on rural hospital diagnoses and procedures.
Type: Database
Sponsoring organization: Agency for Healthcare Research and Quality
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Home Health Compare
Provides information on quality of care provided by Medicare-certified home health agencies, including skilled nursing care, physical and occupational therapy, and home health aide services.
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Nursing Home Compare
Provides detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.
Type: Database
Sponsoring organization: Centers for Medicare and Medicaid Services
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 12/5/2017