Document Type

Fact Sheet


University of Montana Rural Institute

Publication Date



Community Health and Preventive Medicine | Public Health


Rural access to health care has historically been a concern in the United States. In the late 1980s and early 1990s, lower rural reimbursements for the same services provided in urban areas contributed to a substantial decline in the number of rural hospitals and health care providers. Rural Americans with and without disabilities experienced the negative consequences of those changes. The rapid introduction of managed care is producing explosive changes in the marginal, aging, rural medical care services sector. Managed care policies directly affect both access to medical services by people with disabilities and the economic infrastructure of small rural communities. The RTC: Rural, in collaboration with the Research and Training Center on Managed Care at the National Rehabilitation Hospital Center for Health and Disability Research, is studying managed care’s effect on rural Americans with disabilities. Despite managed care’s constantly-shifting landscape and the scarcity of data on disability and managed care, some trends are emerging.


health and wellness, managed care, health care, rural, disability


© RTC: Rural, 2000

Granting Agency

National Institute on Disability and Rehabilitation Research


This publication is funded by a grant from the National Institute on Disability and Rehabilitation Research, U.S. Dept. of Education (H133B70017-01).

Project Number