Rural Health
Resources by Topic: Medical homes
Transforming Tribal Health: Addressing American Indians and Alaska Natives Health Disparities
Recording of a June 8, 2023, conference session on addressing tribal health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Includes presentations from the Arizona Health Care Cost Containment System on the use of care coordination and care management strategies and the National Indian Health Board on rethinking how CMS approaches health equity for American Indians and Alaska Natives. Transcript available in the video description.
Additional links: Carrie Field, National Indian Health Board - Presentation Slides, Leslie Short, Arizona Health Care Cost Containment System - Presentation Slides
Date: 06/2023
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Recording of a June 8, 2023, conference session on addressing tribal health disparities as part of the Centers for Medicare & Medicaid Services (CMS) Health Equity Conference. Includes presentations from the Arizona Health Care Cost Containment System on the use of care coordination and care management strategies and the National Indian Health Board on rethinking how CMS approaches health equity for American Indians and Alaska Natives. Transcript available in the video description.
Additional links: Carrie Field, National Indian Health Board - Presentation Slides, Leslie Short, Arizona Health Care Cost Containment System - Presentation Slides
Date: 06/2023
Type: Video/Multimedia
Sponsoring organization: Centers for Medicare and Medicaid Services
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Adoption of Health System Innovations: Evidence of Urban-Rural Disparities from the Ohio Primary Care Marketplace
Examines the market penetration of Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs), patient-centered medical homes (PCMHs), and the meaningful use of electronic health records (EHRs) among primary care providers (PCPs) in Ohio between 2011 and 2015. Compares the percentage of PCPs who are affiliated with ACOs, PCMHs, and meaningful use by urban and rural county status.
Author(s): Joseph E. Tanenbaum, Mark Votruba, Douglas Einstadter, Thomas E. Love, Randall D. Cebul
Citation: Journal of General Internal Medicine, 36(6), 1584–1590
Date: 06/2021
Type: Document
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Examines the market penetration of Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs), patient-centered medical homes (PCMHs), and the meaningful use of electronic health records (EHRs) among primary care providers (PCPs) in Ohio between 2011 and 2015. Compares the percentage of PCPs who are affiliated with ACOs, PCMHs, and meaningful use by urban and rural county status.
Author(s): Joseph E. Tanenbaum, Mark Votruba, Douglas Einstadter, Thomas E. Love, Randall D. Cebul
Citation: Journal of General Internal Medicine, 36(6), 1584–1590
Date: 06/2021
Type: Document
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Strengthening Primary Care and Improving Population Health: Nebraska's Approach
Explores efforts to strengthen primary care in Nebraska through Patient-Centered Medical Homes, Accountable Care Organizations (ACOs), and the Comprehensive Primary Care Plus program. Discusses the development of pilot programs and a partnership with a local nonprofit and the University of Nebraska College of Public Health.
Author(s): Martha Hostetter, Sarah Klein
Date: 04/2021
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Explores efforts to strengthen primary care in Nebraska through Patient-Centered Medical Homes, Accountable Care Organizations (ACOs), and the Comprehensive Primary Care Plus program. Discusses the development of pilot programs and a partnership with a local nonprofit and the University of Nebraska College of Public Health.
Author(s): Martha Hostetter, Sarah Klein
Date: 04/2021
Type: Document
Sponsoring organization: Milbank Memorial Fund
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Community Social Determinants and Health Outcomes Drive Availability of Patient-Centered Medical Homes
Examines the geographic distribution of patient-centered medical homes and whether they appear in communities with greater disease burdens and social vulnerability. Analyzes spatial clusters of mental and physical health surveys, health behaviors, and premature mortality and compares these metrics with medical home saturation and sociodemographic characteristics, including rurality.
Author(s): Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lopez-De Fede
Citation: Health & Place, 67, 102439
Date: 01/2021
Type: Document
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Examines the geographic distribution of patient-centered medical homes and whether they appear in communities with greater disease burdens and social vulnerability. Analyzes spatial clusters of mental and physical health surveys, health behaviors, and premature mortality and compares these metrics with medical home saturation and sociodemographic characteristics, including rurality.
Author(s): Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lopez-De Fede
Citation: Health & Place, 67, 102439
Date: 01/2021
Type: Document
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The Rural Health Care Coordination Network Partnership Program: Avera St. Mary's Completing the Circle Project
Describes and examines the impact of a care coordination program developed by Avera St. Mary's located in Pierre, South Dakota. Used a Patient Centered Medical Home (PCMH) model, providing services to patients with type 2 diabetes, one-third of whom were American Indian. The program's care team connected patients to resources and coordinated the patient's primary care providers, medications, specialists, other health care services, and a variety of social services. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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Describes and examines the impact of a care coordination program developed by Avera St. Mary's located in Pierre, South Dakota. Used a Patient Centered Medical Home (PCMH) model, providing services to patients with type 2 diabetes, one-third of whom were American Indian. The program's care team connected patients to resources and coordinated the patient's primary care providers, medications, specialists, other health care services, and a variety of social services. Funded under the Rural Health Care Coordination Network Partnership Grant Program from 2015-2018.
Date: 2020
Type: Document
Sponsoring organizations: NORC Walsh Center for Rural Health Analysis, University of Minnesota Rural Health Research Center
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RHC - Becoming a Primary Care Medical Home
Presentation slides from an August 2019 webinar discussing how a Rural Health Clinic (RHC) can become a Patient-Centered Medical Home (PCMH). Profiles one RHC in the Mississippi Delta that became both a PCMH and an Accountable Care Organization and details the challenges and benefits of the transition. Part of the Rural Health Clinic Technical Assistance Series.
Date: 08/2019
Type: Video/Multimedia
Sponsoring organizations: Federal Office of Rural Health Policy, National Association of Rural Health Clinics
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Presentation slides from an August 2019 webinar discussing how a Rural Health Clinic (RHC) can become a Patient-Centered Medical Home (PCMH). Profiles one RHC in the Mississippi Delta that became both a PCMH and an Accountable Care Organization and details the challenges and benefits of the transition. Part of the Rural Health Clinic Technical Assistance Series.
Date: 08/2019
Type: Video/Multimedia
Sponsoring organizations: Federal Office of Rural Health Policy, National Association of Rural Health Clinics
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Rationale and Development of a Randomized Pragmatic Trial to Improve Diabetes Outcomes in Patient-Centered Medical Homes Serving Rural Patients
Reports on a randomized trial developed to determine the effectiveness of a health literacy intervention supporting diabetes self-management education compared to enhanced usual care. Clinical trial occurred in six rural clinics in Arkansas that are Patient-Centered Medical Homes (PCMH), targeting patients with uncontrolled type 2 diabetes.
Author(s): Kristie B. Hadden, Connie L. Arnold, Laura M. Curtis, et al.
Citation: Contemporary Clinical Trials, 75, 152-157
Date: 10/2018
Type: Document
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Reports on a randomized trial developed to determine the effectiveness of a health literacy intervention supporting diabetes self-management education compared to enhanced usual care. Clinical trial occurred in six rural clinics in Arkansas that are Patient-Centered Medical Homes (PCMH), targeting patients with uncontrolled type 2 diabetes.
Author(s): Kristie B. Hadden, Connie L. Arnold, Laura M. Curtis, et al.
Citation: Contemporary Clinical Trials, 75, 152-157
Date: 10/2018
Type: Document
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Utilization and Adherence in Medical Homes: An Assessment of Rural-Urban Differences for People with Severe Mental Illness
Discusses whether enrollment in medical homes improves care in rural versus urban settings for people with severe mental illness (SMI). Examines utilization measures of primary care, mental health, emergency department, inpatient hospitalizations, and medication adherence using data derived from North Carolina Medicaid claims from 2004–2007.
Author(s): Mona Kilany, Joseph P. Morrissey, Marisa Elena Domino, et al.
Citation: Medical Care, 56(10), 870-876
Date: 10/2018
Type: Document
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Discusses whether enrollment in medical homes improves care in rural versus urban settings for people with severe mental illness (SMI). Examines utilization measures of primary care, mental health, emergency department, inpatient hospitalizations, and medication adherence using data derived from North Carolina Medicaid claims from 2004–2007.
Author(s): Mona Kilany, Joseph P. Morrissey, Marisa Elena Domino, et al.
Citation: Medical Care, 56(10), 870-876
Date: 10/2018
Type: Document
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Advanced Primary Care: A Key Contributor to Successful ACOs
Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Type: Document
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Type: Document
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Evaluation of the Comprehensive Primary Care Initiative: Fourth Annual Report
Final report evaluating the Centers for Medicare and Medicaid Services four-year Comprehensive Primary Care (CPC) initiative. Examines CPC participants, program implementation, and impact of CPC on clinicians and staff, patient experience, cost, service use, and quality of care. Includes information on rural practices participating in the CPC.
Author(s): Deborah Peikes, Grace Anglin, Stacy Dale, et al.
Date: 05/2018
Type: Document
Sponsoring organization: Mathematica Policy Research
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Final report evaluating the Centers for Medicare and Medicaid Services four-year Comprehensive Primary Care (CPC) initiative. Examines CPC participants, program implementation, and impact of CPC on clinicians and staff, patient experience, cost, service use, and quality of care. Includes information on rural practices participating in the CPC.
Author(s): Deborah Peikes, Grace Anglin, Stacy Dale, et al.
Date: 05/2018
Type: Document
Sponsoring organization: Mathematica Policy Research
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