Understanding and Facilitating Rural Health Transformation

Tools & Resources

Financial Risk Management

Health care organization capacities to moderate risk of harm or optimize risk of benefit relative to Value-Based Care.

Featured Resource

Financial Modeling

Critical Access Hospital Financial Pro Forma - The Rural Health Value team has developed an Excel-based financial modeling tool to help rural hospitals explore long term financial projections under the current Fee For Service (FFS)/cost-based reimbursement systems. “A very helpful tool for facilities that are trying to determine the potential impact of joining an ACO. There’s no telling how much time someone would have to spend to try to put an analysis like this together on their own, or how much confidence they’d be able to place on the estimates that they would come up with on their own.”
   - William Adcock, CFO, Union General Hospital, LA

Community Data

Selecting Rural Data in American Factfinder - This step-by-step Slideshare presentation shows two methods for selecting rural data from the U.S. Census Bureau’s American Factfinder tool, which provides access to a wide range of statistics describing the U.S. population. Learn how to use the Geographic Comparison Tables and direct selection of locations to easily identify data for use in rural health grant applications, community health needs assessments, and more.

Using Data to Understand Your Community - For rural communities or organizations seeking to address the Triple Aim©, using data to better understand your community's population can be a useful starting point. Read on to find useful websites (and how you might best use them) that include demographic, population, health, and other data for ZIP code, city, county, and state-level geographic areas.

Financial Models

Critical Access Hospital Financial Pro Forma - The Rural Health Value team has developed an Excel-based financial modeling tool to help rural hospitals explore long term financial projections under the current Fee For Service (FFS)/cost-based reimbursement systems.

Proactive System Affiliation - An RHV innovation profile: Three small rural hospitals formed an alliance in order to establish a mutually beneficial affiliation with a large regional medical center while remaining locally owned and controlled.

Rural Accountable Care Organization Care Coordination: - An RHV innovation profile: MaineHealth, a not-for-profit, integrated, healthcare delivery network, established the MaineHealth Accountable Care Organization (MHACO) to engage the Centers for Medicare &Medicaid Services and other payers in various ACO contracts.

Rural Health Networks and New Forms of Governance: - An RHV innovation profile: Wilderness Health is a formal collaborative of independent rural and urban hospitals that serves patients across the continuum of care. The network's governance structure enables all members to have an equal voice at the table.

Physician Relationships

How Hospital Leaders Can Build Good Working Relationships with Physicians - As structural and economic alignment among health care providers continues to advance, good working relationships between hospital leaders and physicians will become even more essential to rural health care system success. This brief from the Rural Health Value team explores potential barriers to physician engagement and discusses strategies to help hospital leaders build good working relationships with physicians.

The Physician's Accountable Care Toolkit - The Physician's Accountable Care Toolkit has been developed by the Towards Accountable Care (TAC) Consortium, a consortium of over 40 North Carolina medical associations and organizations. The TAC provides resources (guides, articles, and webinars) to assist providers understand, participate, navigate, lead, and succeed in a value-driven healthcare system. The Physician's Accountable Care Toolkit details Accountable Care Organization (ACO) implementation strategies and operations guidance for physicians. In addition, the TAC has developed unique ACO guides for several physician specialties and community partners.

Service Design

Emergency Department Super Utilizer Programs - 'Super utilizer' patients often present to the emergency department with chronic and low acuity health concerns that are inappropriately addressed in a setting designed to care for acute, episodic, and emergent health conditions. Super utilizer programs identify super utilizers and facilitate alternative care models such as primary care coordination and social service assistance. Super utilizer programs generally improve participant health, reduce emergency department visits, and decrease hospital charges. This Rural Health Value white paper describes super utilizer program design, implementation, operation, and assessment.

Frontier Extended Stay Clinics (FESC): The RHV Team has summarized this innovative rural health care demonstration, that expands service in existing clinics to include extended stay (up to 48 hours) and emergency services.

Hospital Guide to Reducing Medicaid Readmissions - The Agency for Healthcare Research and Quality (AHRQ) recently released this guide aimed toward hospitals at all stages of readmissions reduction work. It has six sections with topics ranging from how to analyze root causes of readmissions to suggestions on providing enhanced services to patients at high risk of readmission. It also includes a set of 13 tools, (available as individual downloads), which range from a Readmission Risk Tool to a Discharge Information Checklist.

Responding to Rural Health's Unique Challenges - The Patient-Centered Outcomes Research Institute (PCORI) is investing in research that will build a body of evidence on effective strategies for health care in rural areas. Learn more about PCORI's various rural innovation projects, such as telehealth care for Parkinson Disease patients and hospital discharge improvement for rural areas. Information on how to get involved in PCORI efforts is also provided.