Competition in Health Care and the Rural Poor

Market competition has been advocated as a possible solution to the rapidly increasing cost of Medicaid programs. However, there have been no major assessments of the impact of this approach on the rural poor. Past efforts have been located in urban areas, where existing HMOs were used to enroll the Medicaid population that elected to join the plans. In 1981 the Arizona Health Care Cost Containment System (AHCCCS, pronounced “access”), a statewide Medicaid experiment involving prepayment and enrollment in health plans, was created. Data from two state‐wide, cross‐sectional telephone surveys indicate that competitive Medicaid programs may be a feasible strategy in rural areas, but without innovative solutions for those ineligible for Medicaid, many of the rural poor will continue to have in adequate access to medical care

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• Comparing the Medical Utilization and Expenditures of Low Income Health Plan Enrollees with Medicaid Recipients and with Low Income Enrollees Having Medicaid Eligibility

  Richard E Johnson, Daniel J Azevedo•Medical Care•1979

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• Medicaid Utilization of Services in a Prepaid Group Practice Health Plan

  Norman A Fuller, Margaret W Patera et al.•Medical Care•1977

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• Examining the Annual Drug Utilization of a Cohort of Low Income Health Plan Members

  Richard E Johnson, Daniel J Azevedo•Medical Care•1979

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