Health and Healthcare in Frontier Areas – 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.

Promising Examples

Health Extension Regional Offices (HEROs)

Updated/reviewed November 2021

• Need: People in rural New Mexico often found it difficult to find and utilize needed resources from the University of New Mexico Health Sciences Center (UNMHSC).
• Intervention: UNMHSC created Health Extension Regional Offices (HEROs), in which HERO agents live in the communities they serve, help identify health and social needs, and link them with UNMHSC and other university resources.
• Results: In their regions, HERO agents' activities have been diverse, including recruiting physicians, mobilizing research funds to address local priorities, working on economic development, training laypeople in Mental Health First Aid, and helping local institutions access UNMHSC resources.

The Health-able Communities Program

Updated/reviewed April 2021

• Need: Expand healthcare access for the more remote residents of 3 frontier counties in north central Idaho.
• Intervention: Consortium of healthcare providers and community agencies used a hybrid Community Health Worker model to augment traditional healthcare delivery services in order to offer a diverse set of healthcare offerings to frontier area residents.
• Results: Increased healthcare access, especially for cancer and chronic disease screening, along with providing education on a diverse array of health topics.

Other Project Examples

Cavity Free at Three

Updated/reviewed October 2023

• Need: In Colorado, 31% of children have experienced dental decay by the time they reach kindergarten. With several frontier and rural counties in Colorado considered Dental Care Health Professional Shortage Areas (HPSAs), options for oral healthcare are limited.
• Intervention: Cavity Free at Three (CF3) works to improve access to preventive oral health for pregnant women and young children.
• Results: CF3 has trained over 6,000 medical and dental professionals in performing preventive dental health. The percentage of children who received oral healthcare from a medical or dental provider before the age of 2 has progressively increased, and Colorado saw reduced cavities starting in 2007.

HopeWest

Updated/reviewed July 2023

• Need: To provide accessible and affordable services to address the challenges associated with aging, serious illness, and grief across rural western Colorado.
• Intervention: A nonprofit, community-sustained healthcare model was created to provide the Program of All-Inclusive Care for the Elderly (PACE), hospice care and palliative care, as well as grief support services for individuals of all ages.
• Results: Since 1993, HopeWest has grown to serve more than 3,000 people annually across five counties in western Colorado.

Rural Experiences for Health Professions Students (REHPS)

Updated/reviewed July 2023

• Need: An ongoing shortage of healthcare providers in rural areas of South Dakota
• Intervention: A 4-week summer program placing health professions students in rural communities.
• Results: Of graduating participants, 71% practice in South Dakota with 30% of those graduates practicing in rural communities with populations fewer than 10,000, or veteran facilities.

San Luis Valley Public Health Partnership

Updated/reviewed December 2022

• Need: Public health departments in Colorado's rural San Luis Valley region desired to share public health services to improve health outcomes in the region.
• Intervention: Six counties joined in a public health cross-jurisdictional sharing arrangement. The partnership has served as a forum for sharing and evaluating opportunities to improve health access and core public health services.
• Results: The partnership has enabled health departments to share expertise and develop regional projects to provide a broader range of public health services.

Medical Home Plus

Updated/reviewed February 2020

• Need: To help reduce diabetes, depression, and stroke risk in rural residents.
• Intervention: A collaborative care model was implemented in the Idaho counties of Clearwater, Idaho, and Lewis.
• Results: Increased number of patients with controlled blood sugar, controlled blood pressure, and higher depression screening rates.