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Managed care in rural markets: availability and enrollment
J A Wysong1, M K Bliss, J W Osborne
1State University of New York, Buffalo, USA.
Journal of Health Care for the Poor and Underserved
|February 16, 1999
Summary
Managed care availability and enrollment differences between urban and rural areas are mainly driven by socioeconomic and health system factors, not just location or population density. Policy decisions should prioritize these characteristics for better outcomes.
Area of Science:
- Health Services Research
- Health Policy Analysis
- Rural Health Disparities
Background:
- Managed care is a critical component of healthcare delivery in both urban and rural settings.
- Understanding the drivers of managed care availability and enrollment is essential for equitable healthcare access.
- Existing research suggests geographic factors may influence managed care, but the role of socioeconomic and health system characteristics requires further investigation.
Purpose of the Study:
- To test the hypothesis that urban-rural disparities in managed care availability and enrollment are primarily explained by population socioeconomic and health system characteristics.
- To compare the explanatory power of socioeconomic/health system factors versus geographic location, population size, or density on managed care outcomes.
- To inform policy decisions regarding managed care by identifying key influencing factors.
Main Methods:
- Regression analysis was employed to assess the variance in managed care availability and enrollment.
- Two groups of variables were analyzed: (1) population socioeconomic and health system characteristics, and (2) geographic location, population size, and density.
- Statistical models were used to determine which set of variables best accounted for observed differences.
Main Results:
- Socioeconomic and health system characteristics significantly explained a greater proportion of the variance in managed care availability and enrollment compared to geographic factors.
- The influence of factors like adjacency to metropolitan areas, population size, or density was less pronounced than that of socioeconomic and health system attributes.
- These findings indicate that non-geographic factors are the primary drivers of managed care disparities.
Conclusions:
- Managed care policy decisions should shift focus from geographic considerations to socioeconomic and health system characteristics of an area.
- Addressing disparities in managed care requires a nuanced understanding of the underlying population and healthcare system attributes.
- Targeting interventions based on socioeconomic and health system factors is likely to be more effective in improving managed care access and enrollment in underserved areas.