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Keith J. Mueller
J. Patrick Hart
May 26, 2023
May 23, 2023
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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.
Author(s): Keith J. Mueller; Andy Coburn; Sam Cordes; Robert Crittenden; J. Patrick Hart; Timothy McBride; Wayne Myers
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Volume 77, Issue 4 (pages 485–510) DOI: 10.1111/1468-0009.00149 Published in 1999
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, political, historical, legal, and ethical dimensions of health and health care policy.