HMOs and managed care: implications for rural physician manpower planning.
American health care is changing dramatically. Health maintenance organizations (HMOs) and other managed care plans are central to this change. Today, the majority of Americans living in metropolitan areas receive their care from these types of plans. The goal of this article is two-fold. First, it will discuss the potential implications of HMOs and managed care for physician needs and supply in rural regions. Second, it will derive insight into alternative approaches for meeting rural health manpower needs by analyzing HMO staffing patterns. As HMOs and other managed care plans expand, rural physicians, their practices, and their patients will almost certainly be affected. As described in this paper, most of these effects are likely to be positive. The staffing patterns used by HMOs provide an interesting point of comparison for those responsible for rural health manpower planning and resource development. HMOs appear to meet the needs of their enrollees with significantly fewer providers than are available nationally or suggested by the federal standards. Moreover, HMOs make greater use of nonphysician providers such as nurse practitioners and physician assistants.
Weiner
J P
JP
School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
D003625:Data Collection; D005069:Evaluation Studies as Topic; D005544:Forecasting; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006280:Health Workforce / Q000639:trends*; D008329:Managed Care Programs / Q000639:trends; D010820:Physicians / Q000706:statistics & numerical data / Q000600:supply & distribution*; D011365:Professional Practice Location / Q000639:trends; D012423:Rural Health / Q000639:trends*; D014481:United States