The changing landscape of health care financing and delivery : How are rural communities and providers responding?
Identifieur interne : 002882 ( Main/Merge ); précédent : 002881; suivant : 002883The changing landscape of health care financing and delivery : How are rural communities and providers responding?
Auteurs : RBID : Francis:521-00-11920Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
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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Francis:521-00-11920Le document en format XML
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<author><name sortKey="Mueller, K J" uniqKey="Mueller K">K. J. Mueller</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>University of Nebraska</s1>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>University of Nebraska</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>University of Southern Maine</s1>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>University of Southern Maine</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><inist:fA14 i1="03"><s1>University of Washington</s1>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<placeName><settlement type="city">Seattle</settlement>
<region type="state">Washington (État)</region>
</placeName>
<orgName type="university">Université de Washington</orgName>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>University of North Dakota; University of Missouri</s1>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>University of North Dakota; University of Missouri</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>U.S. Department of Health and Human Services</s1>
<s3>USA</s3>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>U.S. Department of Health and Human Services</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Coburn, A" uniqKey="Coburn A">A. Coburn</name>
</author>
<author><name sortKey="Cordes, S" uniqKey="Cordes S">S. Cordes</name>
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<publicationStmt><idno type="inist">521-00-11920</idno>
<date when="1999">1999</date>
<idno type="stanalyst">FRANCIS 521-00-11920 INIST</idno>
<idno type="RBID">Francis:521-00-11920</idno>
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<idno type="wicri:Area/Francis/Curation">000734</idno>
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<idno type="MainMerge">000729</idno>
<idno type="wicri:Area/Main/Merge">002882</idno>
</publicationStmt>
<seriesStmt><idno type="ISSN">0887-378X</idno>
<title level="j" type="abbreviated">Milbank q.</title>
<title level="j" type="main">The Milbank quarterly</title>
</seriesStmt>
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<term>Health Policy</term>
<term>Health insurance</term>
<term>Health system</term>
<term>Hospital Facilities</term>
<term>Organizational Change</term>
<term>Population structure</term>
<term>Poverty</term>
<term>Regional difference</term>
<term>Rural Community</term>
<term>Socio-demographic factor</term>
<term>Unemployment</term>
<term>United States Of America</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Etats-Unis</term>
<term>Système de santé</term>
<term>Politique de la santé</term>
<term>Changement organisationnel</term>
<term>Communauté rurale</term>
<term>Différence régionale</term>
<term>Assurance maladie</term>
<term>Equipement hospitalier</term>
<term>Structure de la population</term>
<term>Facteur socio-démographique</term>
<term>Pauvreté</term>
<term>Chômage</term>
<term>Secteur d'activité économique</term>
<term>Medicaid</term>
<term>Année 1995</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Système de santé</term>
<term>Politique de la santé</term>
<term>Assurance maladie</term>
<term>Pauvreté</term>
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<front><div type="abstract" xml:lang="en">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</div>
</front>
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</record>
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