A Newsletter for the HHQI Underserved Populations (UP) Network     |   December 2015

Welcome to the Underserved Populations (UP) Network e-newsletter, the UPDate. This quarterly newsletter provides several summaries of news and/or research that affects underserved populations which may include: Health disparities, underserved regions, dual-eligible, or small home health agencies.
Underserved Population (UP) Network Announcements

Save the Date
Underserved Populations (UP)
Quarterly Networking Event

"Improving Care Transitions in Rural Settings"
Thursday, January 21, 2016  |  2-3pm (ET)

Care transitions in rural communities can be difficult. The University of Montana's Rural Institute have been working to innovatively improve care transitions which will include:  
  • Common barriers
  • Intervention strategies
  • Implications for population health
Guest Speakers: Dr. Joseph Knapp, International Heart Institute of Montana
Craig Ravesloot,PhD, Rural Institute, University of Montana
Heidi Boehm, RN, CCRN, St. Patrick Hospital Montana

Did you miss October's UP Networking Webinar?

The 1-hr webinar provided insights and education related to the Veterans Care Coordination Center. Learn about eligibility for veterans' services, qualifications, and services to assist senior veterans and their spouses obtain the Aid and Attendance Pension benefit.

Guest Speaker: 
Jeremy Novak, Business Development Manager
Veterans Care Coordination Center 

UP Network Webinar Schedule:
All webinars will be held from 2-3pm ET. Unless specified below, topics for UP Network webinars on the following dates are to-be-determined. Check this page periodically for additional information as it becomes available, or subscribe to the UPDate to receive details and registration links as soon as they are available.

  Improving Care Transitions in Rural SettingsJanuary 19January 18January 17
April 20April 19April 18
July 20July 19July 18
October 19October 18

UP News & Highlights

Rural Health Quiz

1. Approximately 1 in ___ people live in a rural area.
A. 3
B. 5
C. 10
D. 25
2. The percentage of counties deemed rural in the U.S. is ___.
A. 35%
B. 45%
C. 55%
D. 65%
3. Potentially avoidable hospitalizations in rural settings are  ___ than other residential locations.
A. Higher
B. Similar
C. Lower

AHRQ 2014 Chartbook on Rural Health Care - Answers:  1. B; 2. D; 3. A

Snapshot of Rural Health Issues  

People living in rural areas are typically older, poorer, and sicker than those in urban settings.

Patients living in rural (non-core) areas have:
  • Higher rates of using hospital, emergency room, or clinic as source of ongoing care
  • Lower rates of available sources of care at night or on weekends
  • Higher rates of hospitalization admissions for influenza
  • Lower rates of receiving recommended diabetic services
  • Higher rates of uncontrolled diabetes' hospitalization
  • Lower colorectal screenings
  • Higher suicide deaths
Cardiovascular disease (CVD) and risk factors are more significant with people living in rural settings. Even within the rural setting differences persist within gender and race/ethnicity groups.
  • Older women are more vulnerable to develop hypertension if living in rural settings
  • CVD mortality rates are the highest for people living in poor and rural areas, especially with African Americans
  • Mortality rates for stroke are the highest in the Southeast
    • Adults > 35 years are the highest risk in MS, AL, GA, TN, & SC
    • African Americans have a two to three times higher mortality rate than white people
    • People living in Appalachia have high rates of stroke and heart attack 
Warren, J.W. & Smalley, K.B. (2014). Rural Public Health - Best Practices and Preventive Models. New York, NY. 

Interventions need to be tailored to address rural culture, sense of community, health literate, and include patient-centered goals.

The following charts are from the CDC NCHS Data Brief (July 2014) which adds insight to the snapshot of the health of rural patients.

Tools & Resources

Agency for Healthcare Research and Quality (AHRQ)
Office of Rural Health (ORH) - collaboration of U.S.Department of Veterans Affairs, federal and state partners, and rural communities. Includes information, tools, and resources for community partnerships to serve veterans in rural locations 

Rural Health Research Gateway - provides information and access to publications and projects funded by the Federal Office of Rural Health Policy 

Rural Hospitals Innovate to Meet New Health Care Challenges (Hospitals & Health Networks®, 2015) - Examples of how hospitals are collaborating and innovating with community partners to address rural health issues
Rural Transporation.org - advocacy, education, research, and training for the nation's regional planning and economic development organizations

Seekins, T., Hartsell, A., & Spas, D. (2006). Faith Based Organizations and Rural Transportation. University of Montana ScholarWorks.

Warren, J.W. & Smalley, K.B. (2014). Rural Public Health -
Best Practices and Preventive Models. New York, NY.

For more information or to suggest future UP topics or speakers,
please contact us at HHQI@wvmi.org.
Click here for more information about the HHQI National Campaign.
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This material was prepared by Quality Insights, the Medicare Quality Innovation Network-Quality Improvement Organization supporting the Home Health Quality Improvement National Campaign, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The views presented do not necessarily reflect CMS policy. Publication number 11SOW-WV-HH-ADL-121415