Rural Home Health Services – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

Perinatal Health Partnership Southeast Georgia

Updated/reviewed February 2023

• Need: In 12 rural southeast Georgia counties, high-risk pregnant individuals potentially face adverse birth outcomes, including maternal or infant mortality, low birthweight, very low birthweight, or other medical or developmental problems.
• Intervention: An in-home nursing case management program for high-risk pregnant individuals in order to maximize pregnancy outcomes for mothers and their newborns.
• Results: Mothers carry their babies longer and the babies are larger when born, leading to improved health outcomes.

Other Project Examples

Bridges to Care Transitions-Remote Home Monitoring and Chronic Disease Self-Management

Updated/reviewed December 2019

• Need: Decrease hospital readmissions and emergency room visits for patients in rural Tidewater, Virginia.
• Intervention: After inpatient admission or ER visit, identify at-risk patients to offer enrollment in remote monitoring and disease self-management education and coaching, with a special focus on behavioral health wellness.
• Results: Decreased readmissions and ER visits paired with high patient satisfaction scores.