Population Health Evaluation: The Role of CAHs in Providing Core Health Care Services in Rural Communities

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The purpose of this project was to analyze the efforts of CAHs to develop systems of care that support the provision of these core health care services and to identify opportunities for CAHs to develop core health care services in their own communities. It explored opportunities for FORHP and state Flex grantees to support CAHs in achieving the Flex Program goal of developing rural systems of care that meet the population health needs of their communities. The project culminated in two policy briefs: the first summarized the development of select core health care services by CAHs and rural systems of care, while the second discussed the ways in which state Flex programs can support the development of these core health services and rural systems of care with CAHs as the hubs. 


Rural residents suffer from significant gaps in access to “core health care services” including primary care, emergency medical services, long-term care, mental health and substance abuse services, oral health care, and public health services. Given the higher rates of chronic illness (e.g., diabetes and hypertension) and preventable conditions (e.g., obesity) experienced by rural residents, a strong case can be made for the inclusion of chronic care management in this list of core services. Although resource constraints in rural communities can limit the capacity to sustain a full range of health services, the Institute of Medicine has defined a list of core health care services that are essential to meeting the health needs of rural populations and should be provided at the community level by rural systems of care. Since its implementation, a central goal of the Flex Program has been the development of rural systems of care with CAHs as the hubs. This project built on the FMT’s body of work focused on the role of CAHs in their communities and the development of rural systems of care.