Rural Health
Resources by Topic: Care coordination
Marshall Browning Spotlight Video
Profiles Marshall Browning Hospital, a participant in the 2019 cohort of the Delta Region Community Health Systems Development Program (DRCHSD). Describes how shifting the Marshall Browning Hospital mission statement led to improvements to care coordination and transitional care services. Transcript available below description.
Date: 05/2023
Sponsoring organization: National Rural Health Resource Center
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Profiles Marshall Browning Hospital, a participant in the 2019 cohort of the Delta Region Community Health Systems Development Program (DRCHSD). Describes how shifting the Marshall Browning Hospital mission statement led to improvements to care coordination and transitional care services. Transcript available below description.
Date: 05/2023
Sponsoring organization: National Rural Health Resource Center
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Evaluation of the Maternal Opioid Misuse (MOM) Model Second Annual Report (Implementation Year 1)
Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's first implementation year, July 1, 2021–June 30, 2022. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 04/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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Provides an overview of the Maternal Opioid Misuse Model, which provides evidence-based integrated care and care coordination for pregnant and postpartum Medicaid beneficiaries with opioid use disorder (OUD). Describes activities MOM Model awardees undertook during the MOM Model's first implementation year, July 1, 2021–June 30, 2022. Discusses barriers pregnant and postpartum people with OUD face in accessing high-quality, continuous care, specifically in rural areas.
Additional links: Findings at a Glance
Date: 04/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, Insight Policy Research
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Rural Healthcare Disparities in the United States: Can Our Payer Structures Help Us Get Upstream?
Describes a care model utilizing community health workers (CHWs) to engage patients by screening for diseases, and offering education and information to help them manage their chronic conditions in an accessible, non-traditional settings such as a food bank distribution centers, county fairs, livestock auctions, and educational events in rural Idaho. Discusses the value of CHWs, along with a primary care team, in improving outcomes for populations at risk, and the absence of payment models to support this model.
Author(s): Kelly McGrath
Citation: Journal of General Internal Medicine, 38 (Suppl 1), 16-17
Date: 03/2023
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Describes a care model utilizing community health workers (CHWs) to engage patients by screening for diseases, and offering education and information to help them manage their chronic conditions in an accessible, non-traditional settings such as a food bank distribution centers, county fairs, livestock auctions, and educational events in rural Idaho. Discusses the value of CHWs, along with a primary care team, in improving outcomes for populations at risk, and the absence of payment models to support this model.
Author(s): Kelly McGrath
Citation: Journal of General Internal Medicine, 38 (Suppl 1), 16-17
Date: 03/2023
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Achieving Whole Health: A New Approach for Veterans and the Nation
Report offers guidance for providers both inside and outside of the VA for filling gaps in veterans healthcare. Discusses a team-based interprofessional care structure for preventing disease and promoting well-being. Highlights some considerations for providing a whole health approach for rural veterans as well.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 02/2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Report offers guidance for providers both inside and outside of the VA for filling gaps in veterans healthcare. Discusses a team-based interprofessional care structure for preventing disease and promoting well-being. Highlights some considerations for providing a whole health approach for rural veterans as well.
Additional links: Read Online
Author(s): Board on Health Care Services
Date: 02/2023
Sponsoring organization: Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine
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Filling Behavioral Health Gaps in Rural Communities: A Unique Partnership in Washington State
Discusses a collaboration between a Critical Access Hospital (CAH) in Washington and state hospitals to accept patient transfers by utilizing swing beds to care for patients with complex behavioral health and social needs, such as substance use disorder, mental health, homelessness, and more. Includes data on swing bed admissions and information on incorporating behavioral health services into primary care.
Author(s): Sarah Klein, Martha Hostetter
Date: 02/2023
Sponsoring organization: The Commonwealth Fund
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Discusses a collaboration between a Critical Access Hospital (CAH) in Washington and state hospitals to accept patient transfers by utilizing swing beds to care for patients with complex behavioral health and social needs, such as substance use disorder, mental health, homelessness, and more. Includes data on swing bed admissions and information on incorporating behavioral health services into primary care.
Author(s): Sarah Klein, Martha Hostetter
Date: 02/2023
Sponsoring organization: The Commonwealth Fund
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Care Coordination and Community Partnerships for Cancer Care in Critical Access Hospitals
Presents findings from a survey of 135 Critical Access Hospitals (CAHs) regarding care coordination practices for patients with cancer. Describes the types of care coordination services provided by CAHs and the staff that provide these services. Discusses partnerships between CAHs and community organizations regarding cancer initiatives.
Author(s): Megan Lahr, Xiomara Santana, Nathan Bean, Helen Parsons, Ira Moscovice
Date: 01/2023
Sponsoring organization: Flex Monitoring Team
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Presents findings from a survey of 135 Critical Access Hospitals (CAHs) regarding care coordination practices for patients with cancer. Describes the types of care coordination services provided by CAHs and the staff that provide these services. Discusses partnerships between CAHs and community organizations regarding cancer initiatives.
Author(s): Megan Lahr, Xiomara Santana, Nathan Bean, Helen Parsons, Ira Moscovice
Date: 01/2023
Sponsoring organization: Flex Monitoring Team
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Engaging Rural Communities to Incorporate Social Determinants in Developing Strategies to Improve Access to Health Care in the Missouri Bootheel Counties
Presents a study on how social determinants of health affect healthcare access in several rural counties in Missouri. Discusses the perceived barriers to care in the rural "Bootheel" counties, such as economic issues, lack of health insurance coverage, and lack of coordinated care, among others.
Author(s): Ashish Shrestha, Katherine Stamatakis, Janice Ballard
Citation: Rural and Remote Health, 23, 7678
Date: 01/2023
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Presents a study on how social determinants of health affect healthcare access in several rural counties in Missouri. Discusses the perceived barriers to care in the rural "Bootheel" counties, such as economic issues, lack of health insurance coverage, and lack of coordinated care, among others.
Author(s): Ashish Shrestha, Katherine Stamatakis, Janice Ballard
Citation: Rural and Remote Health, 23, 7678
Date: 01/2023
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Rural Wisconsin Chronic Disease Toolkit 2023
Toolkit describing rural-relevant best practices that have been successful in improving chronic disease outcomes and population health. Provides resources to address communication, Body Mass Index, diabetes care, blood pressure control, chronic disease management, and more.
Date: 2023
Sponsoring organization: Rural Wisconsin Health Cooperative
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Toolkit describing rural-relevant best practices that have been successful in improving chronic disease outcomes and population health. Provides resources to address communication, Body Mass Index, diabetes care, blood pressure control, chronic disease management, and more.
Date: 2023
Sponsoring organization: Rural Wisconsin Health Cooperative
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Coordinated Specialty Care for First Episode Psychosis: Costs and Financing Strategies
Report discusses the costs and funding options for coordinated specialty care (CSC) as an early intervention for patients experiencing their first episode of psychosis. Presents a systemic review of studies examining CSC costs and highlights current financing strategies. Makes recommendations for behavioral health organizations and features states expanding coverage of CSC to rural areas.
Date: 2023
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Report discusses the costs and funding options for coordinated specialty care (CSC) as an early intervention for patients experiencing their first episode of psychosis. Presents a systemic review of studies examining CSC costs and highlights current financing strategies. Makes recommendations for behavioral health organizations and features states expanding coverage of CSC to rural areas.
Date: 2023
Sponsoring organization: Substance Abuse and Mental Health Services Administration
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Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2021
Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Offers a summary of the findings from the prior annual reports on the CCBHC demonstration, a comparison of cost and quality in the first two demonstration years, and the results of impact analyses. This is the fifth annual report to Congress on the CCBHC demonstration.
Date: 11/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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Provides an overview of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Offers a summary of the findings from the prior annual reports on the CCBHC demonstration, a comparison of cost and quality in the first two demonstration years, and the results of impact analyses. This is the fifth annual report to Congress on the CCBHC demonstration.
Date: 11/2022
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, Mathematica
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