Population Health and Health Policy

Webinar on Integrating Behavioral Health in Rural Primary Care

John Gale of the Maine Rural Health Research Center, USM Muskie School, will be co-presenting a webinar on rural behavioral health and primary care integration issues on 2/26/15 from 2-3:30 pm ET. Join this webinar to get an overview of integration models used in rural settings, planning best practices, financing considerations, and implementation strategies for primary care and behavioral health providers to collaborate and better meet the behavioral health needs of their communities.

Early Lessons Learned in Implementing MaineCare Health Homes

Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights key lessons learned from the first year of implementation of the MaineCare Health Homes Initiative.

Key Findings:

  • MaineCare's Health Homes Initiative has expanded Maine's capacity for chronic care management in primary care practices and community care teams (CCTs);
  • CCTs provide valuable additional support to patients of Health Homes, including home visits and social supports in the community;
  • Flexibility in program design allowed for wide variation of service delivery models within CCTs;
  • Three percent of Health Home members were referred to CCTs by the end of the first year, but overall practice referral rates varied by CCT--from 1% to 7% of Health Home members within their associated practices.

To view or download the full study, click here

To view or download the Issue Brief on enrollment in the first year of MaineCare Health Homes implementation, click here

Suggested Citation: Fox K, Gray C, Rosingana K. Early Lessons Learned in Implementing MaineCare Health Homes. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Implementation.pdf

MaineCare Health Homes Enrollment in the First Year of Implementation

Abstract: 

This Issue Brief, authored by researchers at the University of Southern Maine's Muskie School, highlights enrollment trends and characteristics of MaineCare's Health Homes initiative during the first year of implementation.

Key Findings:

  • MaineCare initially estimated 42,000 members were Health Home eligible; 48,000 members were enrolled by December 2013;
  • Health Homes practices increased referrals to Community Care Team (CCT) services over the course of the first year of the initiative, increasing from 60 members enrolled in CCTs in January 2013 to 1,392 in Decmber (3% of Health Home members);
  • Health Home members had an average of three chronic conditions.  Two out of the five most common conditions were behavioral health related.

To view or download the full study click here

To view or download the Issue Brief on implementation in the first year of MaineCare's Health Home Initiative click here

Suggested Citation: Fox K, Gray C, Rosingana K. MaineCare Health Homes Enrollment in the First Year of Implementation. Portland, ME: University of Southern Maine, Muskie School of Public Service; September, 2014.

Publication Type: 
Research and Policy Brief
Publish Date: 
September 30, 2014
URL: 
http://muskie.usm.maine.edu/Publications/PHHP/MaineCare-HealthHomes-Enrollment.pdf

Rural and Remote Food Environments and Obesity

Abstract: 

Researchers at the Maine Rural Health Research Center Rural have published a review in the January 2015 issue of Current Obesity Reports describing the rural community, home, and individual food environments and what is known about their roles in healthy eating.

Abstract: Rural residents are more likely to be obese and overweight compared to their urban counterparts. Studies of specific rural communities have found that the limited availability of healthy foods in the community and home as well as individual characteristics and preferences contribute to poor diet and overweight. The rural food environment is varied and may be affected by climate, regional and cultural preferences, transportation access, and remoteness among other factors. Given this diversity and the vulnerabilities of rural residents, who are more likely to have low-income, substandard housing or low educational attainment compared to their urban counterparts, policy and programmatic interventions should target specific needs and communities.

Suggested Citation: Lenardson, J. D., Hansen, A. Y., & Hartley, D. (2015). Rural and remote food environments and obesity. Current Obesity Reports. doi: 10.1007/s13679-014-0136-5

Publication Type: 
Journal Article
Publish Date: 
January 30, 2015
URL: 
http://link.springer.com/article/10.1007%2Fs13679-014-0136-5#page-1

Rural Health Clinic Readiness for PCMH Recognition

Abstract: 

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). Researchers at the Maine Rural Health Research Center (University of Southern Maine) present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for efforts to support RHC capacity development.

Key Findings

  • Based on their performance on the “must pass” elements and related key factors, Rural Health Clinics (RHCs) are likely to have difficulties gaining National Center for Quality Assurance’s (NCQA) Patient-Centered Medical Home (PCMH) Recognition.
  • RHCs perform best on standards related to recording demographic information and managing clinical activities, particularly for those using an electronic health record.
  • RHCs perform less well on improving access to and continuity of services, supporting patient self-management skills and shared decision-making, implementing continuous quality improvement systems, and building practice teams.
  • RHCs are likely to need substantial technical assistance targeting clinical and operational performance to gain NCQA PCMH Recognition.

For more information on this study, please contact John Gale.

Suggested Citations:

(Working Paper) Gale JA, Croll Z, Hartley D. Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2015. Working Paper No. 57.

(Policy Brief) Gale J, Croll Z, Hartley D.Rural Health Clinic Readiness for Patient-Centered Medical Home Recognition: Preparing for the Evolving Healthcare Marketplace. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2015. Research & Policy Brief PB-57.

 

Publication Type: 
Working Paper
URL: 
http://muskie.usm.maine.edu/Publications/rural/RHC-Readiness-for-PCMH-Recognition-Working-Paper

Research staff book chapter contributions win award

Rural Public Health: Best Practices and Preventive Models, published by Springer Publishing Company, wins second place in the 2014 American Journal of Nursing Awards. Research staff at the Maine Rural Health Research Center contributed chapters to this book. Congratulations to John Gale, David Hartley, David Lambert, Jennifer Lenardson, Karen Pearson, and Erika Ziller!
Book Cover: Rural Public Health

Safety of Rural Nursing Home-to-Emergency Department Transfers: Improving Communication and Patient Information Sharing across Settings

Abstract: 

This article was published in the January/February 2015 issue of the Journal for Healthcare Quality, and reports on the evaluation of a demonstration in 10 rural communities to improve the safety of nursing facility (NF) transfers to hospital emergency departments by forming interprofessional teams of hospital, emergency medical service, and NF staff to develop and implement tools and protocols for standardizing critical interfacility communication pathways and information sharing. The research team at the USM Muskie School worked with each of the 10 interprofessional teams to document current communication processes and information sharing tools and to design, implement and evaluate strategies/tools to increase effective communication and sharing of patient information across settings.

For more information on this study, please contact Judy Tupper.

Suggested citation: Tupper JB, Gray CE, Pearson KB, Coburn AF. Safety of Rural Nursing Home-to-Emergency Department Transfers: Improving Communication and Patient Information Sharing across Settings. J Healthc Qual. 2015;37(1):55-65.

Publication Type: 
Journal Article
Publish Date: 
January 13, 2015
Project: 

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