Access to primary health care: developing state and local strategies for high risk groups

Competition and a rapidly changing market place have dramatically altered the dynamics of primary health care delivery in urban areas across the US, focusing new attention on access to care for the indigent. Public and private sector policymakers in Boston, Massachusetts, addressed these issues by examining the health status, payer coverage and availability of providers of primary health care for individuals at risk. Strategies were targeted in the areas of health insurance, reimbursement, and provider organisations to improve access to services at the state and local level.