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Rural Health
Resources by Topic: Service delivery models

Improving the Oral Health of Rural Veterans
Report explores rural veterans' access to oral healthcare. Compares the oral health of rural and urban veterans, highlights barriers to oral healthcare in rural areas, and makes recommendations for expanding access to oral healthcare.
Author(s): Annaliese Cothron, Hayam Megally, Don Clermont
Date: 11/2022
Type: Document
Sponsoring organization: CareQuest Institute for Oral Health
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Medicare Shared Savings Program: Rule Changes and Implications for Rural Health Care Organizations
Summarizes changes to the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (SSP) that take effect in January 2023 for current participants, and in January 2024 for organizations applying for a January 1, 2024 start. Discusses the potential impact of these changes on rural health and participation considerations.
Date: 11/2022
Type: Document
Sponsoring organization: Rural Health Value
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State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency: 2022 Update
Examines state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 public health emergency (PHE). Describes the types of Medicaid services that were allowed to be delivered by telehealth and the types of telehealth modality covered before the PHE, in May 2020, and in January 2022. Outlines the status of state Medicaid telehealth flexibilities based on state executive orders and Medicaid agency guidance. Builds on a July 2021 analysis of state Medicaid telehealth coverage, policies, and utilization before and after the COVID-19 PHE.
Author(s): Jacquelyn Rudich, Ann B. Conmy, Rose C. Chum, et al
Date: 11/2022
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Bridging the Digital Divide: Advancing Telehealth Equity
Describes the rise in telehealth use in Massachusetts since the onset of the COVID-19 pandemic and disparities in use across populations. Summarizes the access, quality, and experience factors associated with telehealth from the perspective of patients, providers, and community leaders. Identifies barriers and factors that promoted telehealth use. Offers recommendations for health plans to advance telehealth equity by addressing the root causes of the digital divide, promoting digital inclusion, removing structural and financial barriers to telehealth access, and supporting higher quality and more inclusive care delivery.
Date: 11/2022
Type: Document
Sponsoring organizations: Department of Population Medicine at Harvard Medical School, Harvard Pilgrim Health Care Institute, Massachusetts Association of Health Plans, Massachusetts Health Quality Partners
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Fifth Evaluation Report: Next Generation Accountable Care Organization Model Evaluation
Reports on changes to the Next Generation Accountable Care Organization (NGACO) Model in response to the COVID-19 public health emergency (PHE). Presents information on cumulative model-wide impacts on Medicare spending, utilization, and quality of care, as well as impacts observed in 2020, the model's fifth performance year. The appendices include data on community characteristics, including rurality.
Additional links: Technical Appendices
Date: 11/2022
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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Future of Population Health Efforts for Rural Health Systems
Slides presented at the Becker's Hospital Review 10th Annual CEO + CFO Roundtable Conference in November 2022. Discusses approaches to understanding and addressing social determinants of health, including community health needs assessments (CHNAs) and Accountable Health Communities (AHCs), and offers links to tools and resources. Highlights needs addressed and implementation challenges faced by two rural AHCs.
Author(s): Keith J. Mueller
Date: 11/2022
Type: Document
Sponsoring organization: Rural Policy Research Institute
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CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities
Report outlines the Centers for Medicare & Medicaid Services (CMS) plan for improving health equity and health outcomes across the U.S. for rural, tribal, and geographically isolated communities. Details a 6 priority framework emphasizing the application of a community-informed geographic lens; the collection and use of standardized data; support for healthcare professionals; the optimization of medical and communication technology; the expansion of access to comprehensive healthcare coverage, benefits, and services and supports; and innovation and value-based care. Highlights examples of activities CMS is undertaking in support of each priority and recent CMS efforts that align with each priority.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Advancing Rural Health Equity: Fiscal Year 2022 Year in Review
Summarizes Centers for Medicare & Medicaid Services (CMS) activities in fiscal year 2022 to advance health equity for people living in rural, tribal, and geographically isolated communities. Covers 10 priority focus areas: Medicaid and the Children's Health Insurance Program (CHIP), Medicare, Marketplace, the rural health workforce, payment and delivery system models and demonstrations, long-term services and supports, maternal health, mental health and substance use disorders, quality, and COVID-19.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Veterans Community Care Program: VA Needs to Strengthen Its Oversight and Improve Data on Its Community Care Network Providers
Describes how the U.S. Department of Veterans Affairs (VA) monitors contractor compliance with the Veterans Community Care Program network adequacy standards and related requirements. Examines the extent to which the VA's contractors are meeting network adequacy standards. Discusses the experiences of VA medical facility officials when scheduling routine appointments for veterans. Offers recommendations to ensure that contractors report complete performance data and increase the accuracy of community provider information.
Additional links: Full Report
Date: 11/2022
Type: Document
Sponsoring organization: Government Accountability Office
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A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity
Provides an overview of existing and emerging payment systems and their roles in promoting community health and health equity. Proposes a global payment model for health systems' inpatient, emergency department (ED), and outpatient sites of care with community health and health equity as its organizing features. Includes information on the Pennsylvania Rural Health Model, the ACO REACH model, and other rural-relevant payment models.
Author(s): Anaeze C. Offodile II, Jason B. Gibbons, Samantha Murrell, Donna Kinzer, Joshua M. Sharfstein
Date: 11/2022
Type: Document
Sponsoring organization: National Academy of Medicine
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