Rural Health
Resources by Topic: Service delivery models
MedPAC Payment Basics
Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Series of briefs providing an of Medicare payment systems. Covers payments systems including Accountable Care Organizations (ACO), Critical Access Hospitals (CAH), Federally Qualified Health Centers and Rural Health Clinics, hospital acute inpatient services, and more.
Date: 10/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Changes in Healthcare Utilization Among Medicare Beneficiaries With Diabetes 2 Years Into the COVID-19 Pandemic
Examines changes in healthcare service use by people with diabetes over the course of the COVID-19 pandemic, utilizing 2018-2021 Medicare fee-for-service (FFS) beneficiary data. Includes rural versus urban comparisons of month-by-month and year-by-year changes in usage of telehealth and inpatient services.
Author(s): Xilin Zhou, Linda J. Andes, Deborah B. Rolka, Giuseppina Imperatore
Citation: AJPM Focus, 2(3), 100117
Date: 09/2023
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Examines changes in healthcare service use by people with diabetes over the course of the COVID-19 pandemic, utilizing 2018-2021 Medicare fee-for-service (FFS) beneficiary data. Includes rural versus urban comparisons of month-by-month and year-by-year changes in usage of telehealth and inpatient services.
Author(s): Xilin Zhou, Linda J. Andes, Deborah B. Rolka, Giuseppina Imperatore
Citation: AJPM Focus, 2(3), 100117
Date: 09/2023
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Sociodemographic Inequities in Telemedicine Use Among US Patients Initiating Treatment in Community Cancer Centers During the Ongoing COVID-19 Pandemic, 2020-2022
Evaluates demographic factors associated with use of telehealth within 90 days after starting cancer treatment during the COVID-19 pandemic, utilizing March 2020-March 2023 data of 36,993 cancer patients. Includes data on telehealth inequities by race and ethnicity, insurance, socioeconomic status, rurality, and more.
Author(s): Jenny S. Guadamuz, Xiaoliang Wang, Trevor J. Royce, Gregory S. Calip
Citation: JCO Oncology Practice, 19(12), 1206-1214
Date: 09/2023
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Evaluates demographic factors associated with use of telehealth within 90 days after starting cancer treatment during the COVID-19 pandemic, utilizing March 2020-March 2023 data of 36,993 cancer patients. Includes data on telehealth inequities by race and ethnicity, insurance, socioeconomic status, rurality, and more.
Author(s): Jenny S. Guadamuz, Xiaoliang Wang, Trevor J. Royce, Gregory S. Calip
Citation: JCO Oncology Practice, 19(12), 1206-1214
Date: 09/2023
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Telehealth Use and Access to Neurology Outpatient Clinical Services for Children: An Observational Cohort Study
Analyzes pediatric neurology appointment completion, cancellation, and no-show rates among telehealth users and telehealth non-users at a tertiary care children's hospital in North Carolina. Compares appointment outcomes before and during the first year of the COVID-19 pandemic, including rural versus urban demographic and outcome data.
Author(s): Savithri Nageswaran, Annette Grefe, Shyh-Huei Chen, Eric Kirkendall, Edward H. Ip
Citation: North Carolina Medical Journal, 85(1)
Date: 09/2023
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Analyzes pediatric neurology appointment completion, cancellation, and no-show rates among telehealth users and telehealth non-users at a tertiary care children's hospital in North Carolina. Compares appointment outcomes before and during the first year of the COVID-19 pandemic, including rural versus urban demographic and outcome data.
Author(s): Savithri Nageswaran, Annette Grefe, Shyh-Huei Chen, Eric Kirkendall, Edward H. Ip
Citation: North Carolina Medical Journal, 85(1)
Date: 09/2023
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Exploring Patient Care Navigation in the Medicare Program
Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Presents an overview of patient navigation programs through an environmental scan of literature published between 2013 and 2023 and discussions with key informants at four healthcare organizations. Describes the variety of patient navigation services, types of patients targeted, settings that offer navigation services, staffing, funding, clinical outcomes, and more. Includes a brief discussion of programs targeting patients in rural areas. Identifies implementation and policy considerations and potential barriers to supporting patient navigation services.
Additional links: Annex, Executive Summary
Author(s): Zachary Predmore, Joachim Hero, Stephanie Dellva, et al.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, RAND Health Care
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Environmental Scan on Encouraging Rural Participation in Population-Based TCOC Models
Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Presents results of an environmental scan regarding population-based total cost of care (PB-TCOC) payment models and encouraging rural participation in these models. Describes challenges affecting rural patients and providers; opportunities for alternative payment models (APMs) and PB-TCOC models to address challenges in rural areas; trends in rural providers' participation in APMs; driving care delivery transformation in rural providers, including models that include or target rural participants in their model designs; leveraging financial incentives to improve rural health care; adoption and use of health information technology, including telehealth and data analytics among rural providers; and the measurement of rural providers' performance in APMs.
Date: 09/2023
Sponsoring organizations: HHS Office of the Assistant Secretary for Planning and Evaluation, NORC at the University of Chicago
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Effect of a Telephone-Based Lifestyle Intervention on Weight, Body Composition, and Metabolic Biomarkers in Rural Ohio: Results from a Randomized Pilot Study
Examines the effectiveness of a 15-week telephone counseling intervention encouraging healthy eating and physical activity among 27 rural Ohio adults with overweight or obesity. Provides data on participants' weight, body composition, fasting blood lipids, and inflammatory biomarkers after 15 weeks of intervention. Highlights findings related to weight and cholesterol management, and discusses rural health disparities and access barriers.
Author(s): Xiaochen Zhang, Victoria R. DeScenza, Zachary L. Chaplow, et al.
Citation: Nutrients, 15(18), 3998
Date: 09/2023
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Examines the effectiveness of a 15-week telephone counseling intervention encouraging healthy eating and physical activity among 27 rural Ohio adults with overweight or obesity. Provides data on participants' weight, body composition, fasting blood lipids, and inflammatory biomarkers after 15 weeks of intervention. Highlights findings related to weight and cholesterol management, and discusses rural health disparities and access barriers.
Author(s): Xiaochen Zhang, Victoria R. DeScenza, Zachary L. Chaplow, et al.
Citation: Nutrients, 15(18), 3998
Date: 09/2023
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Maternal, Infant, and Early Childhood Home Visiting Program in Rural America: Policy Brief and Recommendations to the Secretary
Provides an overview of issues related to the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) in rural areas. Discusses the history of home visiting and the MIECHV program, Tribal MIECHV, program structure, eligible models, and promising approaches. Highlights three evidence-based home visiting models in Oregon that receive MIECHV funding. Offers policy recommendations related to improving MIECHV for rural families.
Date: 09/2023
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Provides an overview of issues related to the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) in rural areas. Discusses the history of home visiting and the MIECHV program, Tribal MIECHV, program structure, eligible models, and promising approaches. Highlights three evidence-based home visiting models in Oregon that receive MIECHV funding. Offers policy recommendations related to improving MIECHV for rural families.
Date: 09/2023
Sponsoring organization: National Advisory Committee on Rural Health and Human Services
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Mental Health Outcomes Among Patients Living in US Counties Lacking Broadband Access and Psychiatrists
Presents a study on mental health access for people who live in counties without psychiatrists and broadband coverage. Discusses the expansion of telehealth services for mental healthcare and consultation. Aims to evaluate mental health access in mostly rural counties with a workforce shortage and a lack of broadband access.
Author(s): Tarun Ramesh, Ryan K. McBain, Jonathan H. Cantor, et al.
Citation: JAMA Network Open, 6(9), e2333781
Date: 09/2023
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Presents a study on mental health access for people who live in counties without psychiatrists and broadband coverage. Discusses the expansion of telehealth services for mental healthcare and consultation. Aims to evaluate mental health access in mostly rural counties with a workforce shortage and a lack of broadband access.
Author(s): Tarun Ramesh, Ryan K. McBain, Jonathan H. Cantor, et al.
Citation: JAMA Network Open, 6(9), e2333781
Date: 09/2023
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