Research on Managed Care Organizations in Rural Communities

Krein, Sarah L.; Casey, Michelle

doi:10.1111/j.1748-0361.1998.tb00621.x

Cited by 7 publications

(5 citation statements)

References 25 publications

(16 reference statements)

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“…It is not surprising that many physician assistants and nurse practitioners who practice underserved areas seem to serve as physician substitutes. [96][97][98] The proportion, however, of nonphysician clinicians located in underserved areas is small, and the overall location of nurse practitioners measured across states has been shown to be correlated closely with that of physicians. 99 The growth in training programs for both physician assistants and nurse practitioners greatly exceeds primary care physician residency growth, and therefore the availability of nonphysician clinicians will also grow faster than that of pediatricians.…”

Section: Nonpediatrician Providers Of Pediatric Carementioning

confidence: 99%

The Pediatrician Workforce: Current Status and Future Prospects

Goodman¹,

Anderson²,

Friedman³

et al. 2005

Pediatrics

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ABSTRACT. The effective and efficient delivery of children's health care depends on the pediatrician workforce. The number, composition, and distribution of pediatricians necessary to deliver this care have been the subject of long-standing policy and professional debate. This technical report reviews current characteristics and recent trends in the pediatric workforce and couples the workforce to a conceptual model of improvement in children's health and well-being. Important recent changes in the workforce include (1)

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Section: Nonpediatrician Providers Of Pediatric Carementioning

confidence: 99%

The Pediatrician Workforce: Current Status and Future Prospects

Goodman¹,

Anderson²,

Friedman³

et al. 2005

Pediatrics

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“…There is a growing literature on rural managed care, which, although not specific to acute and long-term care integration, is nonetheless relevant to the question of whether managed care will expand into rural areas and, if so, with what impact (Christianson, 1998;Krein & Casey, 1998). This literature, together with the research to date on integrated acute and long-term care systems, suggests that there are a number of critical issues for states and rural communities to consider as they contemplate ways of redesigning the financing and delivery of services to achieve better integration, access, and quality.…”

Section: The Rural Issues: Is the Rural Medical And Long-term Care Symentioning

confidence: 99%

Models for Integrating and Managing Acute and Long-Term Care Services in Rural Areas

Coburn

2001

J Appl Gerontol

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States and the federal government are searching for new managed-care strategies, such as capitated financing and coordinated case management, that integrate the financing and delivery of primary, acute, and long-term care services. For rural communities, the development of organizational and delivery systems, which better integrate and manage primary, acute, and long term care services, may help address long-standing problems of limited access to long-term care services. This article discusses the concept of integrated acute (medical) and long-term care service networks; model programs; challenges that health care providers, state policymakers, and others have faced in developing these new integrated structures; and the future of service-integration and coordination approaches in rural areas.

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“…There have been some thoughtful articles by Ricketts, Slifkin, and Silberman (1998), Wellever (1998), and Krein and Casey (1998) that explore some of the longer term implications of managed care in rural areas and the special responsibilities that public purchasers have to avoid adverse or unintended consequences. Because this activity is undertaken with elaborately developed contracts between Medicaid agencies and health plans (in the full-risk arrangement), there are possibilities of customizing the models and arrangements to a large extent to attend to rural-related concerns (Rosenbaum, 1997).…”

Section: Literaturementioning

confidence: 99%

Medicaid and Rural Health Care

Hurley¹,

Crawford²,

Praeger³

2002

The Journal of Rural Health

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The impact of Medicaid policies on systems of rural health care has typically been understood in terms of payment methods and rates. But Medicaid agencies have multifaceted influences, including service funding, promotion of access and quality, and infrastructure. We present in this article a general framework to explore these facets and examine literature that has attempted to identify and measure the impacts of the Medicaid program on rural health care systems. While the literature is relatively sparse, there is evidence that rural health systems have been both bolstered and challenged by Medicaid policies in several areas. Several contemporary developments in Medicaid, including increased state flexibility, uneven coverage expansion, and aggressive Medicaid purchasing strategies, suggest that tensions between Medicaid policy and rural health care needs could grow in the future. These tensions provide focus for developing a research agenda that explores the intersection of Medicaid and rural concerns; a number of research questions that would be a part of this agenda are presented.

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Research on Managed Care Organizations in Rural Communities

Cited by 7 publications

References 25 publications

The Pediatrician Workforce: Current Status and Future Prospects

The Pediatrician Workforce: Current Status and Future Prospects

Models for Integrating and Managing Acute and Long-Term Care Services in Rural Areas

Medicaid and Rural Health Care

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