The Nebraska Center for Rural Health Research

Managed Care in Rural America

September 15, 2000

Author: Keith J. Mueller, Ph.D.

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Table of Contents:

Managed Care in Rural America

Managed What?

A Rose By Any Other Name?

Questions That Frame Our Discussion

Part One: What Is Happening Now In Rural America?

The Infrastructure

Commercial/Private Sponsored Managed Care

Rural and Urban Commercial HMO Enrollment, 1995

Commercial HMO Enrollment in Eight States by County Degree of Urbanicity, 1995

Medicaid Managed Care

Distribution of Rural Medicaid HMO/Prepaid Health Plan Enrollment, 1995-96 (n = 703,720 Enrollees)

Decisions Made by States

Design of the Medicaid Managed Care Systems

Market Reform: M+C Experience Change in Medicare+Choice Enrollment: December 1997 to March 2000*

Changes in Medicare+Choice Enrollment, By Location, 1993 - 2000*

Part Two: What Are the Rural Issues? Implementing A Rural Transition

What Makes Rural Different?

How Is Networking Strategy Affected?

Part Three: Where Do We Go From Here?

Assuming Responsibility

The Rupri Center for Rural Health Policy Analysis and The Nebraska Center for Rural Health Research