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Principles of Rural Health Network Development and Management
This primer on the principles of rural health network development is part of a series of technical assistance reports produced under the Networking for Rural Health Project, an initiative to strengthen the rural health care delivery system by fostering the development of rural health networks. The Project was directed by the Alpha Center, now known as AcademyHealth, with grant support from The Robert Wood Johnson Foundation. A primary goal of Networking for Rural Health is to provide a variety of technical assistance tools and services to support network leaders.
Behavioral Health and Medicaid Managed Care
The Uninsured and Hospital ER Safety-Net
The uninsured are one of the major challenges facing communities and health care service providers. Nationally, hospital EDs are a major source of care for this group and a key component of the health care safety-net. Data and benchmarks on the uninsureds’ use of EDs informs decision-makers about this critical gap and helps to shape appropriate solutions.
This report was prepared as a community service publication for an eight county region in Western New York and showed the high degree of variation in ER use in the region at a time when ER service use by the uninsured was becoming a major national concern. This HMS study followed an HMS publication on ED use in Arizona which was in the top five sites for ED use and the uninsured on Google for six months in 2007.
A Manual on Effective Collaboration Between Critical Access Hospitals and Federally Qualified Health Centers
This manual was prepared by HMS Associates and is published by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, and looks at collaboration from a variety of angles. It covers all the basics and highlights three success stories.
With health centers and Critical Access Hospitals both facing increasing demand for services, the need for collaboration has never been greater. The goal, at HRSA, is to encourage strong partnerships between community health centers and Critical Access Hospitals. Collaboration is not always easy, and it is our hope that this manual -- Effective Collaboration Between Critical Access Hospitals and Federally Qualified Health Centers -- can help to promote the many benefits of working together.
Mary K. Wakefield, Ph.D., R.N. Administrator
Kansas Rural Health Systems Improvement Project
Multiple factors are dramatically reshaping the rural health landscape in Kansas and the nation. However, little is known about how small rural communities can realistically improve the financial base of local health care systems and, as importantly, effectively improve those systems to better address population health and maintain essential health care services. Rather, than adopt a “hold-fast, wait-and-see” posture in the face of these multiple challenges, this Project with HMS Associates as the lead consultant, offers opportunities to energetic, forward-thinking rural communities to design, test, and evaluate the risks and rewards of locally conceived or adjusted approaches to rural health systems improvement.
The Project had two major objectives:
1. assisting up to four rural communities in developing improved local health systems and
2. capturing knowledge and experience from each of the local projects for possible replication and for establishment of better informed national and state policies concerning rural health systems
Six Kansas based foundations and the Federal Office of Rural Health Policy allocated over $2.5M for this project. It was predicated upon the belief that health-related data provided directly by the communities themselves and associated analyses will enable communities to successfully grapple with and resolve “pushes and pulls” inherent in restructured roles of health care service providers.
Opioid Use Disorders Systems Development
HMS Associates under the leadership of Gregory Bonk, Founder and Principle Consultant, has assessed needs and helped to define priorities and plans, emphasizing specific roles of participating agencies and most importantly, the expected benefits to the community served and participating providers. HMS has worked extensively with alliances or networks of different sizes and compositions at local, regional, state and national levels.
WHAT REALISTICALLY CAN BE DONE? The complexity of the problem itself is a roadmap for effective integrated and coordinated care. It requires active participation of many sectors of the community in the prevention, treatment and recovery process. The blending together of community-based recovery concepts and treatment, along with traditional clinical interventions and innovations, seems particularly significant. Connectivity between providers and clients, their friends and families is critical.The blending together of community-based recovery concepts and treatment, along with traditional clinical interventions and innovations, seems particularly significant. Connectivity between providers and clients, their friends and families is critical.
A Guide for Rural Health Care Collaboration and Coordination
Safety net health care providers in rural communitiesface a unique combination of challenges, including limited economies of scale, heavy dependence on public payers, low patient volume, and unnecessary duplication of services among providers. Given these circumstances, rural providers like Health Centers/Federally Qualified Health Centers (FQHCs), small rural hospitals, Critical Access Hospitals (CAHs), Rural Health Clinics (RHCs), and local public health departments may perceive some level of competition with each other for limited resources, staff, and patients, which can put key services at risk. This Guide discusses and illustrates through case studies how collaboration and coordination among rural providers can address these issues and improve care for these communities.
A Guide for Rural Health Care Collaboration and Coordination was developed by U.S. Department of Health and Human Services, Health Resources and Services Administration in cooperation with local, state, and national level leaders representing various rural health care organizations. The National Opinion Research Center (NORC) at the University of Chicago was the principle contractor for the Guide. Greg Bonk, through a subcontract with NORC, provided extensive input on the Guide which was to some extent an update to the Manual prepared by HMS Associates in 2010.