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Rural Health
Resources by Topic: Service delivery models

Toolkit: State Strategies to Support Older Adults Aging in Place in Rural Areas
Describes state initiatives helping older rural adults age in place by supporting services allowing them to remain in their homes. Strategies are focused around building the workforce, increasing access to services in rural areas, and addressing social determinants of health. Includes examples of programs that have already been implemented as well as emerging ideas from several states across the country.
Author(s): Neva Kaye, Kristina Long
Date: 09/2019
Type: Document
Sponsoring organizations: Health Resources and Services Administration, National Academy for State Health Policy, National Organizations of State and Local Officials
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A Framework for Evaluating the Return on Investment of Telehealth
Proposes a framework for calculating the return on investment (ROI) of a telehealth program. Identifies principles and considerations related to evaluating telehealth ROI. Includes a case study focused on a rural community hospital implementing a telecardiology program. Another case study features a hospital system with a tertiary hospital and smaller community hospitals adding pre-transfer video consults.
Author(s): Jacqueline Marks, Jared Augenstein, Anthony Brown, Sol Lee
Date: 09/2019
Type: Document
Sponsoring organization: Manatt Health Strategies
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State Strategies to Address Opioid Use Disorder Among Pregnant and Postpartum Women and Infants Prenatally Exposed to Substances, Including Infants with Neonatal Abstinence Syndrome
Identifies state strategies to improve outcomes for pregnant and postpartum women with opioid use disorder and infants prenatally exposed to substances, including opioids. Discusses strategies focused on access to and coordination of quality services, including approaches such as telemedicine that are useful in rural areas. Also discusses strategies related to provider awareness and training and other topics.
Author(s): Charlan D. Kroelinger, Marion E. Rice, Shanna Cox, et al.
Citation: MMWR (Morbidity and Mortality Weekly Report), 68(36), 777-783
Date: 09/2019
Type: Document
Sponsoring organization: Centers for Disease Control and Prevention
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Evaluation of the Accountable Care Organization Investment Model: AIM Implementation and Impacts over Two Performance Years
Evaluation examining the first two years of the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Reports on AIM ACO composition, including rurality. Appendices include detailed information on each AIM ACO.
Additional links: Appendices, Findings at a Glance
Date: 09/2019
Type: Document
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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2019 Physician Assistant Telehealth Survey
Discusses survey results of 95 physician assistants (PAs) across Kansas, Missouri, and Oklahoma regarding their use and perceptions of telehealth. Examines survey results across a variety of geographic and practice settings. Presents a brief overview of some federal and state-level policies about PA reimbursement and their ability to provide telehealth services.
Date: 08/2019
Type: Document
Sponsoring organization: Heartland Telehealth Resource Center
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Reaching the Quadruple Aim: Workforce and Service Delivery Within Certified Community Behavioral Health Clinics
Summary of data collected between February and August 2019 on the Certified Community Behavioral Health Clinic (CCBHC) model's impact on the behavioral workforce and the aims of improving patient and provider experiences, improving the health of populations, and reducing costs. Discusses access and barriers to care, workforce capacity, primary care and behavioral healthcare integration, and offers recommendations for enhancing financing and reimbursement. Features statistics including populations served by CCBHCs, with breakdowns by urban, rural, and tribal locations.
Author(s): Dana Foney, Shannon Mace, Adriano Boccanelli
Date: 08/2019
Type: Document
Sponsoring organizations: National Council for Mental Wellbeing, University of Michigan Behavioral Health Workforce Research Center
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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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Making Connections: Nationwide Implementation of Video Telehealth Tablets to Address Access Barriers in Veterans
Results of a survey of 68 facility telehealth coordinators to evaluate implementation of a Department of Veterans Affairs initiative to provide tablets to high-need veterans with chronic conditions. Features statistics including demographics of tablet recipients and tablet users, with breakdowns by urban, rural, and highly rural location.
Author(s): Donna M. Zulman, Emily P. Wong, Cindie Slightam, et al.
Citation: JAMIA Open, 2(3), 323–329
Date: 08/2019
Type: Document
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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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Rural Care Coordination and Population Health Management Summit: Summit Findings
Provides guidance to rural hospitals, clinics, and healthcare networks on incorporating community care coordination planning to prepare for population health management. Identifies tools and resources to support the transition to value-based payment models. Summarizes findings from a series of summits with national experts.
Author(s): Rebecca Jolley
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Rural Health Association of Tennessee
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