HMOs reach into rural areas, but enrollment still low
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MINNEAPOLIS—At least three-quarters of HMOs now include at least one rural county in their service area, according to the University of Minnesota Rural Health Research Center. However, while access to managed care has increased substantially for rural Americans, rural HMO enrollment is still low, though on the rise.
About 10% of rural Medicaid recipients are enrolled in Medicaid HMOs and prepaid health plans and 1% in Medicare risk plans. Enrollment is highly concentrated in some states. For instance, seven states have more than half of their rural Medicaid recipients in HMOs while 26 have none of them enrolled.
For commercial populations, rural enrollment is more concentrated in counties adjoining urban areas. There may be several reasons for this trend, the researchers note. Employers in urban areas may have asked plans to offer coverage to employees who live outside the city or rural providers may have approached plans in nearby urban areas. Another explanation could be that urban HMOs want to broaden their population base to keep up with competitors.
An eight-page chartbook produced from the study, Rural Managed Care: Patterns and Prospects, can be downloaded at www.hsr.umn.edu/CENTERS/rhrc/rhc.html.
Two giants in California health care team up to find best practices for access to specialty care; models will be based on consumer feedback
WOODLAND HILLS, CA—Two giants in California health care have teamed up to develop "best practice" models for ensuring access to specialists. California Public Employees’ Retirement System (CalPERS) and HealthNet want to find best models that ensure access without adding to costs or interfering with continuity of care. The project will survey selected groups of patients and physicians in the Health Net network using a Consumer Feedback model developed by California Health Decisions, Inc. (CHD), which is helping to manage the project.. The Medical Quality Commission (TMQC), a nonprofit organization, also manages the program.
"When we asked our members for feedback about how we are performing as their health plan, they asked us to evaluate access to specialty care," said Cindy Gentry, Health Net vice-president, special accounts. Those participating in the initiative stress that the best practices, to be distributed to the industry, will be consumer-driven.
Contact Health Net at 714-540-7387.
HMOs reach into rural areas, but enrollment still low
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