Managed care in rural Minnesota. Family physicians' attitudes and perceptions

Prepaid managed care medicine has become dominant in urban Minnesota and is making its way into the rural setting. This study assesses the attitudes of rural family practice physicians in Minnesota toward managed care. A survey, consisting primarily of five-point Likert scale statements, was mailed to 798 rural Minnesota family practice physicians, with a response rate of 35% (281 respondents). We tabulated overall responses and made comparisons based on practice characteristics and years in practice. Twenty physicians participated in a follow-up telephone interview. We also conducted telephone interviews with 10 representatives from managed care organizations. Both positive and negative attitudes toward managed care emerged. Two-thirds of respondents did not feel that their time with patients was diminished under managed care. However, 67% of respondents felt that managed care organizations had failed to incorporate rural patients' specific needs into their policies. Only 7% of respondents felt that managed care organizations adequately explained their benefits packages to enrollees. Rural family practitioners' apparent disillusionment with current managed care models merits the attention of those concerned with medical care in rural areas.