The Changing Landscape of Health Care Financing and Delivery: How Are Rural Communities and Providers Responding?

Keith J Mueller; Andy Coburn; Sam Cordes; Robert Crittenden; J. Patrick Hart; Timothy McBride; Wayne Myers

doi:10.1111/1468-0009.00149

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The Changing Landscape of Health Care Financing and Delivery: How Are Rural Communities and Providers Responding?

Journal article

Open access

Peer reviewed

The Changing Landscape of Health Care Financing and Delivery: How Are Rural Communities and Providers Responding?

Keith J Mueller, Andy Coburn, Sam Cordes, Robert Crittenden, J. Patrick Hart, Timothy McBride and Wayne Myers

The Milbank quarterly, Vol.77(4), pp.485-510

12/1999

DOI: 10.1111/1468-0009.00149

PMCID: PMC2751134

PMID: 10656030

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Abstract

Rural communities have not kept pace with the recent dramatic changes in health care financing and organization. However, the Medicare provisions in the Balanced Budget Act of 1997 will require rural providers to participate in the new systems. Case studies revealed the degree of readiness for change in six rural communities and charted their progress along a continuum, as reflected in three sets of activities: the development of networking; the creation of new strategies for managing patient care; and the adoption of new methods for contracting with health insurers. Some communities had constructed highly integrated systems, whereas others were just beginning to change their billing practices; a few were signing contracts for capitated care, in contrast to those that were resisting discounts in current fee structures. These six rural areas still have considerable ground to cover before their health care organization and financing reach the levels achieved by urban communities.

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Title: Subtitle: The Changing Landscape of Health Care Financing and Delivery: How Are Rural Communities and Providers Responding?
Creators: Keith J Mueller - University of Nebraska, Lincoln
Andy Coburn - University of Southern Maine, Portland
Sam Cordes - University of Nebraska, Lincoln
Robert Crittenden - Harborview Medical Center, Seattle
J. Patrick Hart - Hart & Associates, North Dakota
Timothy McBride
Wayne Myers - Health Resources and Services Administration, Rockville
Resource Type: Journal article
Publication Details: The Milbank quarterly, Vol.77(4), pp.485-510
DOI: 10.1111/1468-0009.00149
PMID: 10656030
PMCID: PMC2751134
NLM abbreviation: Milbank Q
ISSN: 0887-378X
eISSN: 1468-0009
Publisher: Milbank Memorial Fund
Language: English
Date published: 12/1999
Academic Unit: Health Management and Policy; Public Policy Center (Archive)
Record Identifier: 9984214789902771

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