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Rural Hospitals Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

Franklin Cardiovascular Health Program (FCHP)
Added March 2015
  • Need: To develop sustainable, community-wide prevention methods for cardiovascular diseases in order to change behaviors and healthcare outcomes in rural Maine.
  • Intervention: Local community groups and Franklin Memorial Hospital staff studied mortality and hospitalization rates for 40 years in this rural, low-income area of Farmington to seek intervention methods that could address cardiovascular diseases.
  • Results: A decline in cardiovascular-related mortality rates and improved prevention methods for hypertension, high cholesterol, and smoking.

Promising Examples

Patient Care Connect
Added September 2016
  • Need: Cancer patients living in the Deep South encounter multiple barriers in accessing regular cancer treatment.
  • Intervention: The University of Alabama at Birmingham Comprehensive Cancer Center developed a program that uses lay patient navigators to support and direct patients to appropriate resources to overcome barriers to accessing care.
  • Results: The program has become a model for improving cancer care quality, decreasing unnecessary utilization (ER visits and hospitalizations), removing barriers to care, and enhancing patient satisfaction.

Other Project Examples

Piedmont Mountainside Hospital's Freestanding Emergency Department
Added December 2017
  • Need: The North Georgia Medical Center (NGMC) of Ellijay, Georgia had been losing money and patients. Many residents living in Ellijay were seeking hospital care elsewhere, leaving NGMC treating an average of only 6 patients in the year prior to closing their doors in 2016.
  • Intervention: With approval from the state, Piedmont Mountainside Hospital (PMH) leased the space from NGMC and opened the state's first freestanding emergency department. Medical services were again made available for patients in Ellijay and surrounding areas.
  • Results: Within the first 6 months of operation, over 5,000 emergency visits were made to the freestanding ED, an average of 30 patients per day.
ICAHN External Peer Review Network
Updated/reviewed August 2017
  • Need: Critical access hospitals (CAHs) in rural Illinois required an external mechanism for peer review.
  • Intervention: Using physicians from network member hospitals, a CAH network implemented a peer review process.
  • Results: Staff peer reviews also improved healthcare quality within the CAH network.
Stratus Healthcare Network
Updated/reviewed July 2017
  • Need: Rural Georgia hospitals experiencing the crush of expenses in addition to limited investment capital for resources.
  • Intervention: Hospitals, health care systems, and physicians came together to create an alliance of healthcare providers that focused on value-based healthcare delivery, rather than fee-for-service care, with the goal of developing a clinically integrated network.
  • Results: Now sharing resources and best practices, Stratus Network members are working to reduce excessive or duplicate services, reduce costs of services, and show performance improvements.
University of Mississippi Medical Center: Center for Telehealth
Updated/reviewed July 2017
  • Need: Many rural areas in Mississippi lacked adequate access to specialty healthcare services such as emergency medicine, stroke neurology, pediatric specialists and psychiatrists. Mississippi's health and economic future depended on the implementation of an innovative, culturally-appropriate, community-based effort to improve health outcomes.
  • Intervention: The University of Mississippi Medical Center created the Center for Telehealth to deliver quality specialty services through telehealth video conferencing and remote monitoring tools to the underserved areas of Mississippi.
  • Results: The program has been successfully implemented throughout many of the state's rural hospitals and has reduced transfers and geographic barriers for patients.
funded by the Federal Office of Rural Health Policy Upper Peninsula Pharmacy and Therapeutics Committee
Updated/reviewed July 2017
  • Need: Healthcare entities in the Upper Peninsula region of Michigan were using different formularies, missing opportunities for group purchasing power and consistent care.
  • Intervention: The Upper Peninsula Health Plan and the Upper Peninsula Health Care Network developed a regional partnership for managing prescription costs and quality pharmaceuticals in rural, upper Michigan.
  • Results: More informed pharmaceutical decisions and lowered pharmaceutical costs for Upper Peninsula Health Plan member organizations.
Leadership Development Program
Updated/reviewed June 2017
  • Need: Reasonably-priced leadership education was needed for professional development of healthcare organization managers in southeastern Idaho and western Wyoming.
  • Intervention: Creation of a health network providing leadership training opportunities for member hospitals.
  • Results: Increased leadership and managerial quality, and decreased professional development costs for rural hospitals of southeastern Idaho and western Wyoming.
The Hospital Cooperative Benchmarking Initiative
Updated/reviewed June 2017
  • Need: Healthcare facilities that were part of The Hospital Cooperative (THC) needed a simple, customized benchmarking tool to compare indicators across member hospitals.
  • Intervention: THC developed a benchmarking template that is fast and easy to use.
  • Results: THC collected data semi-annually at each facility, allowing for valuable information and data to be reported to the cooperative quickly.
The Hospital Cooperative Mobile MRI
Updated/reviewed June 2017
  • Need: Critical Access Hospitals in Idaho were not able to afford a fixed MRI system.
  • Intervention: The hospitals partnered to purchase a mobile MRI unit to travel among facilities.
  • Results: The MRI unit went into service in 2012, providing hundreds of scans per month and traveling among six member hospitals in rural Idaho.
Granville Health System's Transitional Care Program
Added April 2017
  • Need: To reduce hospital admissions and improve health for North Carolina patients.
  • Intervention: Granville Health System's Transitional Care Program helps hospital and ED patients schedule follow-up appointments. In addition, the program provides home visits and safety checks.
  • Results: From 2015 to 2016, the number of patients receiving home visits increased from 30 to 86. In addition, 2016 saw a $73,595 reduction in inpatient readmissions and an $11,500 reduction in self-pay readmissions of patients with high-risk diagnoses.
North Region Health Alliance
Updated/reviewed March 2017
  • Need: A telecommunication network for healthcare providers in northeastern North Dakota and northwest Minnesota to provide better healthcare to the region's rural residents.
  • Intervention: The North Region Health Alliance was developed as a collaborative partnership and telecommunication infrastructure that electronically links 21 healthcare providers together.
  • Results: The North Region Health Alliance provides quality telecommunication services to rural healthcare facilities as they work to provide quality healthcare.
funded by the Federal Office of Rural Health Policy Utah Rural Independent Hospital Network
Updated/reviewed March 2017
  • Need: To help ensure the viability of and improve quality at 9 rural, independent hospitals serving 11 Utah counties.
  • Intervention: A network organization was created to allow member hospitals to communicate, network, and undertake projects together.
  • Results: Members took advantage of cost savings, education, and networking opportunities through group projects and programs.
funded by the Federal Office of Rural Health Policy Community Care Partnership of Maine Accountable Care Organization
Added February 2017
  • Need: To increase access and quality of care for Medicare, Medicaid, uninsured, and commercial patients in rural Maine.
  • Intervention: 3 hospitals and 8 Federally Qualified Health Centers in Maine formed the Community Care Partnership of Maine Accountable Care Organization (CCPM ACO).
  • Results: CCPM serves about 70,000 patients in Maine. In addition, it implemented ACO shared savings plans with Maine Medicaid, Medicare, and five commercial health insurance payers in Maine.
Right Side Up Falls Prevention
Updated/reviewed January 2017
  • Need: Falling is one of the leading causes of morbidity and mortality in adults over the age of 65.
  • Intervention: The Right Side Up program was implemented in rural Otter Tail County to address the prevention and management of falls and risk for falls through in-home assessments given by interdisciplinary healthcare professionals and students.
  • Results: Short-term outcomes revealed 100% of participants found the visit and recommendations for falls prevention to be helpful, and 78% implemented these recommendations.
funded by the Federal Office of Rural Health Policy Plymouth Area Transitions Team (PATT)
Updated/reviewed November 2016
  • Need: To prepare patients with complex care needs for discharge from their hospital stay.
  • Intervention: A program was created to ease hospital discharges in the New Hampshire counties of Belknap, Grafton, and Merrimack.
  • Results: Readmissions have decreased in high-risk inpatients and a continuous care coordination focus has been established.
Western Healthcare Alliance Laboratory Services Network
Updated/reviewed November 2016
  • Need: Lack of efficiency for medical laboratory testing for rural western Colorado and Utah hospitals.
  • Intervention: A network that provides education, operations improvement consulting, best practices, and group contracting with discounted services for hospital laboratories.
  • Results: Lower laboratory testing costs with superior quality, greater efficiencies, and improved turnaround times leading to increased quality of healthcare.
Wisconsin Quality Residency Program
Updated/reviewed July 2016
  • Need: To prepare quality improvement leaders for their roles in small rural hospitals or Critical Access Hospitals.
  • Intervention: A program to teach quality improvement methods, leadership and management skills, and networking support to hospital quality leaders.
  • Results: In the program's first year, it has enrolled 38 participants.
Unlicensed Assistive Personnel (UAP) Program
Updated/reviewed June 2016
  • Need: Eastern Montana faced a shortage of nurses, especially in rural and Critical Access Hospitals.
  • Intervention: The Montana Health Network created the Unlicensed Assistive Personnel (UAP) program to recruit nursing students to work in rural hospitals with the incentive of loan forgiveness.
  • Results: The program has placed 28 nursing student UAP at rural hospitals after nursing school completion, and 5 have qualified for loan forgiveness.
Level One Cardiac Care and Partnership
Updated/reviewed March 2016
  • Need: Fast diagnosis and stabilization in order to survive a cardiac emergency in the rural areas around Davenport, Washington.
  • Intervention: Lincoln Hospital is prepared to quickly assess needs, deliver medications, and air transport heart attack patients to Sacred Heart Medical Center in Spokane, Washington.
  • Results: Increased survival rates and other quality of life outcomes for heart attack patients from the rural areas of Lincoln County, Washington.

Last Updated: 12/5/2017