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Building managed care networks for rural communities.

Managed health care networks in both urban and rural communities seek to improve quality, cost, and access; however, rural community health care systems must also curb patient outmigration. A primary care network (PCN) can effectively keep more of the patient care within the rural community. This PCN can then expand to include secondary contractual relationships with the rural community hospital and specialist physicians. As this expanded PCN affiliates with a tertiary provider network, an integrated delivery system (IDS) emerges. This enables the full health care service continuum to be managed by the rural primary care physicians. Such managed cooperation initiatives are best carried out as a joint effort between community employers and providers.