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Rural Health
Resources by Topic: Service delivery models

Addressing Health-Related Social Needs to Improve Rural Health: Ideas to Action
Identifies strategies for building community and regional systems of care to better address the social needs of patients and inform the design of community-level rural health transformation initiatives, pilots, or demonstrations in rural Maine. Examines existing literature and evidence from similar initiatives in Vermont, Idaho, and Oregon, and highlights key observations. Describes key components of a demonstration designed to build, implement, and test strategies for aligning health, social service, and other systems in order to advance whole-person care.
Author(s): Andrew F. Coburn, Deborah A. Deatrick
Date: 09/2021
Sponsoring organizations: Maine Rural Health Action Network, New England Rural Health Association
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An Evaluation of Telehealth Use by Medicare Beneficiaries in 2020
Research brief examining telehealth use for outpatient evaluation and management from January 2019 to December 2020 based on a 20% sample of fee-for-service Medicare beneficiaries. Charts monthly trends for in-person and telehealth visits and compares rural and urban telehealth use, offering policy implications related to rural access to services.
Author(s): Chad Ellimoottil, Ziwei Zhu, Rod Dunn, et al.
Date: 09/2021
Sponsoring organization: University of Michigan Institute for Healthcare Policy and Innovation
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Health Panel Comment Letter – Rural Emergency Hospitals (REH)
Offers comments in response to the Centers for Medicare and Medicaid Services (CMS) Request for Information on Rural Emergency Hospitals (REH). Addresses the type and scope of services REHs could offer, conditions of participation, health equity, collaboration and care coordination, quality measurement, payment, and enrollment.
Date: 09/2021
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Rural Public Health and Health Care: A Scan of Field Practice and Trends
Offers a historical overview of rural healthcare and rural public health theories and practice methods and describes newer theories, such as value-based care, personalized medicine, social determinants of health, and health in all policies. Outlines trends in public health and healthcare, including community engagement, evidence-based decision making, and delivery integration, discussing rural implications of these trends.
Date: 09/2021
Sponsoring organization: Aspen Institute
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Restoring Access to Maternity Care in Rural America
Examines regional partnerships to build rural access to maternity care through hub-and-spoke models of education and support from urban healthcare organizations to rural maternity providers, investments in telehealth, and remote monitoring systems. Discusses barriers to maternity care access in rural areas and highlights local examples of maternal health provider networks, investments in the rural maternity workforce, and policy implications of developing rural maternity care.
Author(s): Martha Hostetter, Sarah Klein
Date: 09/2021
Sponsoring organization: Commonwealth Fund
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Obstacles Persist for Rural Patients to Access Hospice
Discusses challenges to delivering hospice care in rural areas. Highlights changes to allow providers at Rural Health Centers and Federal Qualified Health Centers to serve as attending physicians for hospice patients. Explores the impact of COVID-19 on the delivery of hospice services, including the use of telehealth services and workforce concerns.
Author(s): Jim Parker
Date: 09/2021
Sponsoring organization: Hospice News
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Association of Hospital Telestroke Adoption With Changes in Initial Hospital Presentation and Transfers Among Patients With Stroke and Transient Ischemic Attacks
Results of a study to assess whether implementation of telestroke services is associated with changes in where and how patients present with stroke symptoms, their decision to be transferred to another hospital, and to which hospitals they are transferred. Uses data from 593 hospitals that adopted telestroke from 2009-2016. Features statistics on hospital characteristics by telestroke status, with breakdowns by urban or rural location.
Author(s): Kori S. Zachrison, Jessica V. Richard, Andrew Wilcock, et al.
Citation: JAMA Network Open, 4(9)
Date: 09/2021
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Opportunities Exist to Strengthen Evaluation and Oversight of Telehealth for Behavioral Health in Medicaid
Explores how 37 states evaluated and conducted oversight of telehealth for behavioral health services for Medicaid enrollees in January and February 2020. Discusses states' experiences with telehealth and the impacts of telehealth on access to care, as well as concerns regarding the impact of these services on cost and quality of care. Provides recommendations for states the Centers for Medicare and Medicaid Services (CMS) to meet the behavioral health needs of Medicaid enrollees and prevent fraud, waste, and abuse.
Date: 09/2021
Sponsoring organization: Office of Inspector General (HHS)
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States Reported Multiple Challenges with Using Telehealth to Provide Behavioral Health Services to Medicaid Enrollees
Summarizes results of a January-February 2020 survey of State Medicaid Directors in 37 states that provide behavioral health services via telehealth through managed care organizations. Describes challenges with using telehealth to serve Medicaid enrollees, including provider and enrollee training, internet connectivity, privacy, and technology costs. Offers recommendations for the Centers of Medicare and Medicaid Services (CMS) to help states address these challenges.
Date: 09/2021
Sponsoring organization: Office of Inspector General (HHS)
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Indian Health Service Use of Critical Care Response Teams Has Helped to Meet Facility Needs During the COVID-19 Pandemic
Provides an overview of the Indian Health Service's (IHS) Critical Care Response Teams (CCRTs) program, which was developed to support IHS and Tribal facilities in caring for critically ill COVID-19 patients. Examines the first five CCRT deployments from June -September 2020. Offers recommendations to leverage CCRT program success to support other IHS care improvement efforts.
Date: 09/2021
Sponsoring organization: Office of Inspector General (HHS)
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