Medicaid managed care programs in rural areas: a fifty-state overview

• Published in: Health Affairs Vol. 17; no. 6; pp. 217 - 227
• Main Authors: Slifkin, R T, Hoag, S D, Silberman, P, Felt-Lisk, S, Popkin, B
• Format: Journal Article
• Language: English
• Published: United States Health Affairs 01.11.1998; The People to People Health Foundation, Inc., Project HOPE
• Subjects: Capitation; Case management; Constraints; Cost control; Costs; Data Collection; Enrollments; Environmental management; Flexibility; Government programs; Health care; Health care policy; Health maintenance organizations; Health policy; HMOs; Interviews; Managed care; Managed Care Programs - statistics & numerical data; Medicaid; Medicaid - statistics & numerical data; Medicaid program; Medical service; Medical service, Rural; Participation; Primary care; Program implementation; Resistance; Rural areas; Rural communities; Rural conditions; Rural environments; Rural health care; Rural Health Services - statistics & numerical data; State Health Plans; Statistical analysis; Studies; Travel; United States; Urban areas; Waivers; United States; United States > US
• ISSN: 0278-2715; 1544-5208; 2694-233X
• DOI: 10.1377/hlthaff.17.6.217

Interviews with state Medicaid officials reveal that although managed care programs have been implemented in rural areas, participation remains behind that of urban areas. Many states aim to create a statewide Medicaid managed care program and are struggling to overcome barriers that are greater in rural areas, including providers' resistance, lack of commercial managed care, and inadequate supply of providers. Many have modified contracting strategies and shown flexibility regarding interpretations of travel standards, twenty-four-hour coverage requirements, and primary care case management requirements, to implement programs in rural environments.