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Rural Health
Resources by Topic: Service delivery models

Evaluation of the Maryland Total Cost of Care Model: Progress Report
Provides an overview of the Maryland Total Cost of Care Model and evaluates the first four years of the program, 2019-2022. Explores the effects of the model on Medicare spending; service use, including preventable hospital use; and healthcare quality measures. Estimates the potential impact of switching Maryland to the Medicare prospective payment system (PPS) on Medicare spending and service use, including implications for rural and safety net hospitals.
Additional links: Appendices, Findings at a Glance, Transformation Spotlight
Date: 04/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
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Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: An Updated Systematic Review
Systematic review investigating the impact of telehealth use on health equity for patients with mental health conditions and substance use disorders during COVID-19. Discusses findings in light of previous research. Includes rurality as a demographic group assessed.
Author(s): J. Priyanka Vakkalanka, Khyathi Gadag, Lauren Lavin, et al.
Date: 04/2024
Type: Document
Sponsoring organization: Rural Telehealth Research Center
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The First 1,000 Days of Life: Creating Brighter Futures for New Moms and Babies
Podcast episode featuring a discussion with leaders from Intermountain Healthcare and St. James Health Care in Butte, Montana, regarding how their initiatives provide wraparound and intensive case management services to at-risk new moms from pregnancy through their baby's first two years. Includes a discussion with a former program participant.
Date: 04/2024
Type: Audio
Sponsoring organization: American Hospital Association
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Understanding Planning for Tribal Home Visiting Implementation: A Report From the Multi-Site Implementation Evaluation of Tribal Home Visiting
Examines model implementation of home visiting programs within U.S. indigenous communities. Uses community-engaged approaches to identify planning, implementation, challenges, and supports of the Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) program.
Author(s): Melina Salvador, Kirsten Keene, Tess Abrahamson-Richards, et al.
Date: 03/2024
Type: Document
Sponsoring organization: Administration for Children and Families
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Characteristics and Outcomes of a Hospitalized Cohort with Reduced Mortality from COVID-19, White Mountain Apache Tribal Lands, April 1 – July 31, 2020
Analyzes factors affecting COVID-19 patient outcomes among 2262 American Indian people living on or near White Mountain Apache tribal lands, with data from April 1 to Jul 31, 2020. Highlights the significance of reduced mortality in the study population, and discusses possible impacts of a home visit referral program.
Author(s): Ryan M. Close, Chelsea S. Lutz, T. Shaifer Jones, et al.
Citation: BMC Public Health, 24, 648
Date: 03/2024
Type: Document
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Experiences with and Outcomes of Oral Health Care - Perspectives from Nationally Representative Data
Report discusses the outcomes and experiences with oral healthcare from patients across the United States surveyed in January - February 2023. Details patients experience with access to care, attitudes about co-location of oral healthcare and other types of care, value-based care, telehealth usage, and discrimination in healthcare, among other topics. Breaks down demographic data of survey participants by age, gender, race/ethnicity, and urbanicity, among other measures.
Author(s): Lisa J. Heaton, Morgan Santoro, Paige Martin, Eric P. Tranby
Date: 03/2024
Type: Document
Sponsoring organization: CareQuest Institute for Oral Health
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A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care
Examines the availability of behavioral health providers who actively serve Medicare or Medicaid enrollees in 20 counties, 10 urban and 10 rural, across 10 states in 2021. Explores the extent to which traditional Medicare, Medicare Advantage, and Medicaid enrollees received behavioral health services and whether they used telehealth or in-person services. Offers recommendations to encourage more behavioral health providers to serve these enrollees and expand coverage to additional behavioral health provider types. Includes rural and urban comparisons throughout.
Additional links: Report Highlights
Date: 03/2024
Type: Document
Sponsoring organization: Office of Inspector General (HHS)
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Maternal and Infant Health: HHS Should Strengthen Processes for Measuring Program Performance
Provides an overview of the Healthy Start program, which aims to reduce rates of infant death, improve maternal health outcomes, and reduce racial and ethnic disparities. Describes Healthy Start grantees and participants served during the April 2019-March 2024 grant period, as well as services that grantees are expected to provide and changes to these expectations for the 2024-2029 grant period. Explores the U.S. Department of Health and Human Services's (HHS) efforts to measure program performance, the extent to which Healthy Start performance measures meet key attributes of effective measures, and HHS' efforts to align Healthy Start performance measures with those of related HHS programs. Includes information on Healthy Start programs and participants by organization type, race, and rurality. Offers recommendations regarding reviewing and coordinating Healthy Start performance measures across Healthy Start and related programs.
Additional links: Full Report
Date: 03/2024
Type: Document
Sponsoring organization: Government Accountability Office
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Environmental Scan on Developing and Implementing Performance Measures for Population-Based Total Cost of Care (PB-TCOC) Models
Presents results of an environmental scan regarding the development and implementation of population-based total cost of care (PB-TCOC) payment models. Describes types of performance measures used in value-based payment models and pay-for-reporting programs, data sources used for constructing performance measures, features of PB-TCOC models, challenges in developing and implementing performance measures and opportunities for Alternative Payment Models (APMs) and PB-TCOC models to address these challenges, trends in existing performance measures across several Center for Medicare and Medicaid Innovation (CMMI) models and Medicare value-based care programs, and more. Includes rural references and considerations throughout.
Date: 03/2024
Type: Document
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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