title: Case study. The little HMO that could: heart of America HMO in Rugby, North Dakota.
abstract: What does an HMO need to succeed in rural America? For this 3,000-member health plan, the key ingredients are enlightened self-interest by a committed medical group, support from local employers, low overhead, efficient practice styles, and luck in the form of benevolent state insurance rules. But a catastrophic illness almost doomed the plan in 1992 and convinced leaders of the need to grow.
authors.forename: L
authors.initials: L
authors.lastname: Sternberg
mesh_terms: D002391:Catchment Area, Health / Q000191:economics*; D003363:Cost Control; D004465:Economic Competition; D005544:Forecasting; D006123:Group Practice / Q000191:economics / Q000458:organization & administration; D006279:Health Maintenance Organizations / Q000191:economics / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006780:Hospitals, Rural; D008389:Marketing of Health Services; D009658:North Dakota; D010816:Physician Incentive Plans; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration*