Rural Case Studies

On this page, you can find the latest stories highlighting the good work of our rural members. From innovations in AI to telehealth to new payment models, hospitals and health systems in rural areas are brainstorming bold new ideas worth showcasing here.

Nurse Urges her Rural Alabama Community to Get Vaccinated. A nurse in Tuskegee, Ala., is leading by example: writing a blog on the benefits and safety of COVID-19 vaccines and encouraging others in her rural community to get vaccinated. Cheryl Owens, RN made it her personal mission to educate veterans and all Tuskegee residents about the vaccine’s benefits and safety. She works as a registered nurse at Central Alabama Veterans Health Care System (CAVHCS).

Rural Provider Uses Partnerships to Expand Behavioral Health Services Nationwide. As a rural provider, Sioux Falls, S.D.-based Avera Behavioral Health sees a high rate of suicide and drug overdoses. To help manage these cases, Avera created a full suite of behavioral health care services, including a comprehensive eCARE telehealth solution delivering services in 32 states. Read more in this case study, including details on how Avera uses partnerships via its telepsychiatry network to serve the behavioral health care needs of rural communities nationwide.

Critical Access Hospital in Oregon Uses Advisory Council and Trainings to Improve Cultural Competency. To improve care for its American Indian and Latino patients, St. Charles Madras, a Critical Access Hospital in Oregon, created a Patient Family Advisory Council, implemented cultural competency trainings, and installed new artwork to better represent its community. Read about the evidenced-based program on improving cultural competency and patient satisfaction.

Data-Driven Initiative Drives down Disparities in Rural Health Care. Identifying the underlying factors that contribute to disparities in health outcomes for vulnerable rural populations and developing strategies to address these issues remain constant challenges, but progress is being made. OSF Healthcare’s Health Equities Action Lab (HEAL) is employing a data-driven strategy to address breast cancer disparity outcomes among its Illinois patients, 65% of whom live in rural areas.

The Hospital as a Convener in Rural Communities. In this case study, AHA’s Future of Rural Health Care Task Force explores how rural hospitals can establish themselves as conveners in their communities, working alongside other stakeholders to improve health outcomes.

Partnering to Improve Birth Outcomes in a Rural Community. In 2015, Kearny launched the Pioneer Baby program in partnership with KU School of Medicine-Wichita to improve pregnancy and birth outcomes by reducing pregnancy complications, premature births, low- or extremely high-birth weight, and cesarean sections while increasing breastfeeding rates. The hospital also tapped outside funding, such as grants and local large employers, to upgrade computer software and purchase a 4D ultrasound machine.

Advancing Rural Telehealth and Addressing Its Challenges. The telehealth program at a small Texas hospital serves as one example of how trustees who closely interacted with administrators helped to lead the hospital’s timely use of telehealth during the COVID-19 pandemic. At Yoakum Community Hospital, a 23- bed critical access hospital, leaders shared plans with its board for fast-tracking telehealth services that had begun two years prior for psychiatry and primary care. Read the story in AHA Trustee Insights.

Exploring Options to Deploy Capitated Payments to Enhance Primary Care in Rural SettingsThis case study highlights examples of capitated payment agreements that serve to increase the use and improve the quality of primary care services in rural communities. These arrangements are deployed at several levels of care management and delivery in the public and private sectors, with payment to parties such as managed care organizations, community health workers and physicians. Most of these models are enmeshed in larger, multi-agreement payment models and serve as an example of how to leverage capitated payments for specific services in conjunction with other payment methodologies such as fee-for-service, pay-for-value, and global budgeting.

Doulas Enhance the Birthing Experience - Brookings Health System, Brookings, SDBrookings Health System established the state’s first free doula program for delivery and postpartum care, staffed by volunteers. The nine-year old program also receives high marks from patients and hospital staff.

Best Practices Approach to Treating Maternal Hemorrhage - Titus Regional Medical Center, Mount Pleasant, Texas. Since implementing best practices related to maternal hemorrhaging, Titus Regional Medical Center’s maternal morbidity rate related to blood loss has been reduced significantly. The hospital employs a stage-based approach to maternal hemorrhage, simulates for staff emergent hemorrhage situations and provides intense education regarding the physiology of a hemorrhage.

Community Health Workers at Northeastern - Vermont Regional Hospital, St. Johnsbury, Vt. Northeastern Vermont Regional Hospital (NVRH), St. Johnsbury, VT and its Community Connections (CoCo) program has been on the vanguard of the CHW initiative. Their outcomes are impressive.

Artificial Intelligence in Rural Health Care: Where to Begin? >Artificial Intelligence (AI) means many things to many people, but to the consumer it means convenience. At Winona (Minn.) Health, AI has been introduced as a way to reduce cost, improve access and improve the patient’s experience of care. To date, that experience is running 97% favorable.

Building Primary Care from the Ground Up: Training Rural Residents in Williston, ND. Entering its fifth year, the program has graduated 8 family physicians four of whom have stayed and practice in western North Dakota.

Providence Health-Fairfield Emergency Room Winnsboro, SC Hospital-based Freestanding ED. Perhaps not the first choice, but ultimately the best choice for this rural community, the new ER stabilizes what has been a steady decline in health care services in Winnsboro over the past few years.

Walking the Path toward Self-determination and Improving the Populations’ Health the “Nuka” Way. Cherokee Indian Hospital strives to be a “Cherokee community” hospital continuously improving the health status of the tribe and sensitive to the culture and values of the community.

Dare County’s Employee Wellness Program at Outer Banks Hospital. The hospital’s collaboration with the Dare County Department of Public Health − in particular, as a contractor for the county’s employee health and wellness plan – provides a potent example of how hospitals in rural areas can make the most of local partnerships to improve the health and well-being of the communities they serve.

The Value Initiative Members in Action: Dartmouth-Hitchcock Medical Center – Lebanon, N.H.

The Value Initiative Members in Action: Redesign the Delivery System: Purchase of Retail Pharmacy Enhances Services to the Community

The Value Initiative Members in Action: Presbyterian Healthcare Services – Albuquerque, NM

The Value Initiative Issue Brief 4: How Rural Hospitals Improve Value and Affordability


2020 Rural Hospital Interventions for Coronavirus (COVID-19) Case Studies

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