Rural Health
Resources by Topic: Care coordination
Patient Experience and Function, Fall 2018 Cycle: CDP Report
Evaluates 5 new measures related to patient function and experience of care and supports using them for quality improvement efforts and public reporting. Measures focus on care coordination, particularly following discharge in order to reduce hospital readmissions. Includes Critical Access Hospitals under acute care hospitals, with exclusions for swing bed stays.
Date: 08/2019
Type: Document
Sponsoring organization: National Quality Forum
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Evaluates 5 new measures related to patient function and experience of care and supports using them for quality improvement efforts and public reporting. Measures focus on care coordination, particularly following discharge in order to reduce hospital readmissions. Includes Critical Access Hospitals under acute care hospitals, with exclusions for swing bed stays.
Date: 08/2019
Type: Document
Sponsoring organization: National Quality Forum
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Mobile Telehealth Units and Care Coordinators Improve Emergency Care Services for Rural Arizona Patients
Features an Arizona program focused on lowering ER readmissions through care coordination and EMS telehealth services. Explains how the telehealth services are provided via mobile telehealth units. Describes how care coordination helps meet the behavioral health needs of patients with chronic diseases.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 08/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Features an Arizona program focused on lowering ER readmissions through care coordination and EMS telehealth services. Explains how the telehealth services are provided via mobile telehealth units. Describes how care coordination helps meet the behavioral health needs of patients with chronic diseases.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 08/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Support and Services at Home (SASH) Evaluation: SASH Evaluation Findings, 2010-2016
Evaluates the Support and Services at Home (SASH) program in Vermont, which provides support services and care coordination for older adults and people with disabilities in conjunction with affordable housing. Addresses Medicaid and Medicare expenditures, medication management, property management, challenges, and lessons learned. Identifies the percent of rural SASH host properties and differences for rural areas.
Additional links: Highlights
Author(s): Amy Kandilov, Vincent Keyes, Noëlle Siegfried, et al.
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Evaluates the Support and Services at Home (SASH) program in Vermont, which provides support services and care coordination for older adults and people with disabilities in conjunction with affordable housing. Addresses Medicaid and Medicare expenditures, medication management, property management, challenges, and lessons learned. Identifies the percent of rural SASH host properties and differences for rural areas.
Additional links: Highlights
Author(s): Amy Kandilov, Vincent Keyes, Noëlle Siegfried, et al.
Date: 07/2019
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Operationalizing an Implementation Framework to Disseminate a Care Coordination Program for Rural Veterans
Features a study on a framework for assessment prior to the implementation of a care coordination program in Veterans Affairs (VA) facilities. Details a nurse-led care coordination program and highlights the methods for assessing the local context of the program before implementation.
Author(s): Chelsea Leonard, Heather Gilmartin, Marina McCreight, et al.
Citation: Journal of General Internal Medicine, 34, 58-66
Date: 05/2019
Type: Document
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Features a study on a framework for assessment prior to the implementation of a care coordination program in Veterans Affairs (VA) facilities. Details a nurse-led care coordination program and highlights the methods for assessing the local context of the program before implementation.
Author(s): Chelsea Leonard, Heather Gilmartin, Marina McCreight, et al.
Citation: Journal of General Internal Medicine, 34, 58-66
Date: 05/2019
Type: Document
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Practical Use of Process Mapping to Guide Implementation of a Care Coordination Program for Rural Veterans
Details a study on the use of process mapping in the implementation of a care coordination program in Veterans Affairs (VA) facilities. Discusses a nurse-led care coordination program and outlines its implementation process.
Author(s): Marina S. McCreight, Heather M. Gilmartin, PhD, Chelsea A. Leonard, et al.
Citation: Journal of General Internal Medicine, 34, 67-74
Date: 05/2019
Type: Document
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Details a study on the use of process mapping in the implementation of a care coordination program in Veterans Affairs (VA) facilities. Discusses a nurse-led care coordination program and outlines its implementation process.
Author(s): Marina S. McCreight, Heather M. Gilmartin, PhD, Chelsea A. Leonard, et al.
Citation: Journal of General Internal Medicine, 34, 67-74
Date: 05/2019
Type: Document
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Are Rural and Urban Emergency Departments Equally Prepared to Reduce Avoidable Hospitalizations?
Presents the results of a cross-sectional, web-based survey sent to medical directors and/or nurse managers from 135 hospital-based emergency departments (EDs) in Michigan. Examines the rural and urban differences in the presence of clinical pathways, services to reduce admissions, barriers connecting patients to outpatient services, and the availability of resources to reduce or prevent avoidable admissions.
Author(s): Margaret B. Greenwood-Ericksen, Michelle L. Macy, Jason Ham, et al.
Citation: Western Journal of Emergency Medicine, 20(3), 477-484
Date: 05/2019
Type: Document
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Presents the results of a cross-sectional, web-based survey sent to medical directors and/or nurse managers from 135 hospital-based emergency departments (EDs) in Michigan. Examines the rural and urban differences in the presence of clinical pathways, services to reduce admissions, barriers connecting patients to outpatient services, and the availability of resources to reduce or prevent avoidable admissions.
Author(s): Margaret B. Greenwood-Ericksen, Michelle L. Macy, Jason Ham, et al.
Citation: Western Journal of Emergency Medicine, 20(3), 477-484
Date: 05/2019
Type: Document
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Leveraging Medicaid Financing and Coverage Benefits to Deliver PrEP Intervention Services
Shows how stakeholders in Medicaid agencies, Medicaid managed care organizations, and public health departments can identify barriers to pre-exposure prophylaxis (PrEP) medication and clinical services, in an effort to prevent HIV. Includes a section on provision of PrEP through Federally Qualified Health Centers and Rural Health Centers, and through telehealth.
Author(s): Naomi Seiler
Date: 05/2019
Type: Document
Sponsoring organization: AcademyHealth
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Shows how stakeholders in Medicaid agencies, Medicaid managed care organizations, and public health departments can identify barriers to pre-exposure prophylaxis (PrEP) medication and clinical services, in an effort to prevent HIV. Includes a section on provision of PrEP through Federally Qualified Health Centers and Rural Health Centers, and through telehealth.
Author(s): Naomi Seiler
Date: 05/2019
Type: Document
Sponsoring organization: AcademyHealth
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Reducing Cancer Among Native Populations: Models for Research, Prevention, and Treatment
Highlights the work of a cancer researcher, a foundation director, and healthcare provider who are engaging American Indians and Alaska Natives in cancer research, prevention, and treatment.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 05/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Highlights the work of a cancer researcher, a foundation director, and healthcare provider who are engaging American Indians and Alaska Natives in cancer research, prevention, and treatment.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 05/2019
Type: Document
Sponsoring organization: Rural Health Information Hub
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Evaluating Breast Cancer Care Coordination at a Rural National Cancer Institute Comprehensive Cancer Center Using Network Analysis and Geospatial Methods
Examines geographic access data for breast cancer patients served by a National Cancer Institute Comprehensive Cancer Center in New England. Discusses cancer care coordination, physician networks, and care network density (the amount of patient sharing among providers in a care network) to evaluate healthcare quality and outcomes.
Author(s): Erika L. Moen, Nirav S. Kapadia, A. James O'Malley, Tracy Onega
Citation: Cancer Epidemiology, Biomarkers and Prevention, 28(3), 455-461
Date: 03/2019
Type: Document
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Examines geographic access data for breast cancer patients served by a National Cancer Institute Comprehensive Cancer Center in New England. Discusses cancer care coordination, physician networks, and care network density (the amount of patient sharing among providers in a care network) to evaluate healthcare quality and outcomes.
Author(s): Erika L. Moen, Nirav S. Kapadia, A. James O'Malley, Tracy Onega
Citation: Cancer Epidemiology, Biomarkers and Prevention, 28(3), 455-461
Date: 03/2019
Type: Document
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VA and Indian Health Service: Actions Needed to Strengthen Oversight and Coordination of Health Care for American Indian and Alaska Native Veterans
Report discusses the relationship between the Department of Veterans Affairs (VA) and the Indian Health Service (IHS) with regard to providing care to American Indian and Alaska Native veterans. Details the cooperative agreement between the two entities and the ways their efforts could be improved.
Additional links: Full Report
Date: 03/2019
Type: Document
Sponsoring organization: Government Accountability Office
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Report discusses the relationship between the Department of Veterans Affairs (VA) and the Indian Health Service (IHS) with regard to providing care to American Indian and Alaska Native veterans. Details the cooperative agreement between the two entities and the ways their efforts could be improved.
Additional links: Full Report
Date: 03/2019
Type: Document
Sponsoring organization: Government Accountability Office
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