Rural Project Examples Addressing Health conditions

The Minnesota Integrative Behavioral Health Program

Updated/reviewed May 2023

Need: Out of 79 Critical Access Hospitals (CAHs) surveyed in Minnesota in 2015, behavioral health was the most frequently cited service requested.
Intervention: In response, Rural Health Innovations launched the Minnesota Integrative Behavioral Health Program. This initiative engaged representatives across all sectors in health integration between hospital, primary care, and community services.
Results: Strategy sessions resulted in the creation of resource directories to improve care coordination, evaluation measurements to document results, and an overall better understanding of integrative care challenges.

Updated/reviewed February 2023

Need: Teen pregnancy and sexually transmitted diseases, including HIV, in young girls were concerns for members of Union Parish, Louisiana.
Intervention: Union General Hospital, a Critical Access Hospital, created the program It's a Girl Thing: Making Proud Choices to teach prevention, self-confidence, and personal responsibility to teen girls.
Results: Teen pregnancy rates in Union Parish have dropped by 18%, exceeding the program's initial goal of 5%. Graduation rates have also increased the longer girls remain in the program.

Updated/reviewed June 2022

Need: Evidenced-based intervention to improve function and quality of life for patients with chronic obstructive pulmonary disease and other chronic lower respiratory conditions.
Intervention: Pulmonary rehabilitation program implementation in 1989.
Results: Compared to a national average of only about 3% of referred Medicare beneficiaries actually enrolling in pulmonary rehabilitation, 60% of the program's referred patients enroll. Averaging around 15 patients/year completing the program, a large combined cardiac and pulmonary rehabilitation maintenance population averages 8,000 visits/year.

Updated/reviewed June 2022

Need: Improved behavioral health care offerings for a community after losing 5 senior-aged men to suicide.
Intervention: A Critical Access Hospital in Yoakum, Texas, created a community-based program focusing on inpatient and outpatient behavioral health care for area residents age 50 and older.
Results: A financially-sustainable behavioral health care delivery model demonstrating positive impacts on physical health conditions, healthcare service utilization, and high patient satisfaction rates.

Added April 2021

Need: Population health approach to decreasing area deaths from cardiovascular disease.
Intervention: A health system-level investment in level II cardiac catheterization services and the required specialized cardiology workforce.
Results: Since August 2018, the Avita Health System in north central Ohio has provided local cardiovascular services that have decreased hospital transfers, increased care coordination, and provided education and prevention activities that, with time, will impact population health cardiovascular outcomes.

Updated/reviewed April 2021

Need: Ending a local Vermont population's homelessness experience.
Intervention: In 2010, Pathways Vermont implemented a first-of-its-kind, rural-focused Housing First program in order to provide housing and support services to those with mental health and substance use conditions experiencing homelessness.
Results: Since its initial start-up, Pathways Vermont has assisted over 560 Vermonters — about 70% from rural areas — experiencing homelessness using the Housing First model. The organization has collaborated with the state mental health department, corrections department, local healthcare systems and providers, and other organizations to end homelessness. In addition, programmatic work has expanded to reach other local populations, including veterans and at-risk families.

Updated/reviewed March 2020

Need: Comprehensive cancer services for residents of an 8-county, 3-state area in Appalachia.
Intervention: Using a Cancer Patient Navigation Tool Kit, a Maryland acute care facility led a multidisciplinary collaboration that provided the area's patients with expanded cancer treatment services.
Results: In addition to several new cancer-related programs, expanded services are now available for cancer patients, families, and cancer survivors.

Updated/reviewed February 2020

Need: To help reduce diabetes, depression, and stroke risk in rural residents.
Intervention: A collaborative care model was implemented in the Idaho counties of Clearwater, Idaho, and Lewis.
Results: Increased number of patients with controlled blood sugar, controlled blood pressure, and higher depression screening rates.

Updated/reviewed December 2019

Need: Organized effort targeting COPD patients' medical needs in order to prevent hospital readmission in Zanesville, Ohio.
Intervention: Creation of an integrated system model using nurse navigators that incorporates evidence-based chronic disease care management approaches to COPD care.
Results: Improved readmission rates and overall improved acute and chronic care for the area's COPD patients.

Updated/reviewed December 2019

Need: A healthcare delivery model to improve health and well-being of Pennsylvania patients with serious mental illness in Pennsylvania, especially those in rural settings.
Intervention: County human service administrators, patients, families, a behavioral health provider network, and a nonprofit behavioral health managed care organization implemented 2 versions of a behavioral home health model focusing on a complete culture of wellness.
Results: These unique models significantly increased patient activation, engagement in both primary and specialty care, and improved client perception of their mental health status.