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Rural Health
Resources by Topic: Service delivery models

Geospatial Analysis of Access to Health Care and Internet Services in the US
Study examining access to healthcare and internet services based on 2015-2019 American Community Survey data. Discusses implementations of findings for telemedicine expansion and the need for improved internet access to address rural-urban health disparities.
Author(s): Emefah C. Loccoh, Amanda Nguyen, Gaeun Kim, Haider J. Warraich
Citation: JAMA Network Open, 5(11), e2243792
Date: 11/2022
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A Scoping Review of Applications of the Consolidated Framework for Implementation Research (CFIR) to Telehealth Service Implementation Initiatives
A scoping review of the literature examining the application of the Consolidated Framework for Implementation Research (CFIR) relating to telehealth implementation initiatives. Searches 5 academic databases from 2010 to 2021 to review 64 peer-reviewed articles discussing CFIR and telehealth implementation initiatives. Includes articles that discuss telehealth implementation in rural and tribal areas.
Author(s): Pavani Rangachari, Swapandeep S. Mushiana, Krista Herbert
Citation: BMC Health Services Research, 22, 1450
Date: 11/2022
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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
Sponsoring organization: CareQuest Institute for Oral Health
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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
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
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
Sponsoring organizations: Centers for Medicare and Medicaid Services, NORC at the University of Chicago
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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
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
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
Sponsoring organization: National Academy of Medicine
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Person-Centered Innovation – An Update on the Implementation of the CMS Innovation Center's Strategy
Provides an update on the Centers for Medicare and Medicaid Services' (CMS) Innovation Center's progress in the implementation of the strategy refresh announced in 2021. Describes accomplishments from the first year of implementing the strategy refresh and outlines areas of focus for the upcoming year across the five strategic objectives: driving accountable care, advancing health equity, supporting innovation, addressing affordability, and partnering to achieve healthcare system transformation. Includes information on the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model and the Community Health Access and Rural Transformation (CHART) Model.
Additional links: Supplemental Document
Date: 11/2022
Sponsoring organization: Centers for Medicare and Medicaid Services
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