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Rural Health
Resources by Topic: Healthcare quality

Implementation Challenges and Opportunities Related to HPV Vaccination Quality Improvement in Primary Care Clinics in a Rural State
Examines quality improvement interventions to increase human papillomavirus (HPV) vaccination rates in a rural Midwestern state. Describes the disparity in HPV vaccination rates between rural and urban areas. Discusses the roles of providers, clinics, and health systems in implementing interventions.
Author(s): Natoshia M. Askelson, Grace Ryan, Laura Seegmiller, et al.
Citation: Journal of Community Health, 44(4), 790-795
Date: 08/2019
Type: Document
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Transformation Support Provided Remotely to a National Cohort of Optometry Practices
Describes the results of a practice transformation and quality improvement project for optometry practices. Compares cost-savings and emergency department avoidance data between rural and urban practices.
Author(s): Ronald N. Adler, Warren J. Ferguson, Hussein Antar, et al.
Citation: Annals of Family Medicine, 17(5), S33-S39
Date: 08/2019
Type: Document
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Medicaid: Efforts to Identify, Predict, or Manage High-Expenditure Beneficiaries
Describes strategies used in 7 states to manage beneficiaries' healthcare costs while ensuring quality care, and lists resources the Centers for Medicare and Medicaid Services provides to help states identify, predict, and manage high-expenditure beneficiaries. Discusses effects of social determinants of health and staff shortages in rural areas. Includes statistics for Medicaid expenditures among beneficiaries enrolled only in Medicaid, for fiscal years 2009-2011.
Additional links: Full Report
Date: 08/2019
Type: Document
Sponsoring organization: Government Accountability Office
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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Organizational Challenges to Improving Quality of Care in Indian Health Service Hospitals
Identifies organizational issues hindering the Indian Health Service (IHS) from improving the management of IHS hospitals. Discusses concerns related to formal structure, policies and roles; awareness of hospital performance and problems; and IHS officials' confidence in the agency's ability to make sustained improvements. Recommends strategies for improvement.
Author(s): Suzanne Murrin
Date: 08/2019
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Impact of Rural and Urban Hospital Closures on Inpatient Mortality
Examines the impact of California's hospital closures from 1995-2011 on adjusted inpatient mortality for sepsis, stroke, asthma/chronic obstructive pulmonary disease, and acute myocardial infarction. Features statistics including the number of closures by year, patient demographics with breakdowns by urban or rural location, and differential impacts of rural and urban closures with breakdowns by condition.
Author(s): Kritee Gujral, Anirban Basu
Citation: NBER Working Paper Series, Working Paper 26182
Date: 08/2019
Type: Document
Sponsoring organization: National Bureau of Economic Research
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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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Geriatrics and Palliative Care, Fall 2018 Cycle: CDP Report
Evaluates 5 quality measures related to geriatrics and palliative care and supports using them for quality improvement efforts and reporting programs. The measures include 1) improvement in ambulation/locomotion; 2) improvement in bathing; 3) improvement in bed transferring; 4) improvement in management of oral medication; and 5) improvement in pain interfering with activity. The measures were not risk-adjusted for rurality.
Date: 08/2019
Type: Document
Sponsoring organization: National Quality Forum
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Developing Risk-Adjusted Avoidable Hospitalizations and Emergency Department Visits Quality Measures: Final Report
Defines avoidable hospitalization (AH) and avoidable emergency department (ED) visits (AVs) and summarizes the development of a model for calculating expected AH and AV rates using Medicare claims data. Seeks to inform Medicare quality payment models and target areas for quality improvement. Table 3-10 includes AH and AV risk-standardized rates for a number of rural market areas.
Author(s): Zhanlian Feng, Benjamin Silver, Micah Segelman, et al.
Date: 08/2019
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, RTI International
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Accelerating Value-Based Payment in California's Federally Qualified Health Centers: Options for Medicaid Health Plans
Highlights examples of value-based payment (VBP) models for Federally Qualified Health Centers (FQHCs), including a rural Hawaii model and a Colorado model that incorporates rural FQHCs. Covers Accountable Care Organization (ACO) models, state-led Capitated Alternative Payment Models (APMs), state-led quality payment adjustments, and Medicaid shared savings ACO models. Addresses how FQHCs and health plans can overcome challenges when launching new VBP models and offers recommendations for California's health plans.
Author(s): Greg Howe, Tricia McGinnis, Rob Houston
Date: 08/2019
Type: Document
Sponsoring organization: Center for Health Care Strategies
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