title: Competition in health care and the rural poor: an assessment from Arizona's competitive Medicaid experiment.
abstract: Market competition has been advocated as a possible solution to the rapidly increasing costs 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 Costs 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.
mesh_terms: D001130:Arizona; D003625:Data Collection; D004465:Economic Competition; D004467:Economics; D008484:Medicaid / Q000191:economics*; D008489:Medical Indigency; D012423:Rural Health; D013223:Statistics as Topic