The West Virginia University Robert C. Byrd Health Sciences Center proposes to create a Rural Managed Care Demonstration Center through a statewide consortium led by its office of Rural Health. This consortium consists of an interdisciplinary team of rural health policy leaders from the state academic centers and Bureau of Public Health. This managed care demonstration center proposes to build on rather than duplicate other managed care proposals in the state such as the West Virginia Rural Health Networking Project which provides funding for the planning and establishment of at least three integrated health networks in rural areas of West Virginia and the Public Employees Insurance Agency's rural-based, managed care proposals that cover PEIA beneficiaries in rural West Virginia Counties. The West Virginia Rural Managed Care Demonstration Center proposes to build on the managed care demonstration projects described above by supporting activities that promote the delivery of cost-effective, quality care while promoting competition among rural, regional networks in terms of quality of care and cost efficiency. The specific objectives are: a) planning and development of a regional data processing center that would facilitate inter-organizational integration of computerized data that could generate practice profiles that provide meaningful data on cost, service use, and outcomes, b) development of physician/ practitioner study groups for the purpose of continuing education in managed care issues that directly relate to the role of the primary care practitioner, c) utilization of patient survey instruments to measure patient satisfaction, functional status, and/or quality of life, d) incorporation of principles of managed care into the education of students currently training at rural sites within the rural managed care demonstration networks, e) Development of a consortium for rural health services and policy research that will oversee the health services research needs of the rural managed care demonstration networks, and f) development of an ombudsman program within each network to investigate consumer complaints. Specific methodology will include a) the devotion of a full time health care information and management systems manager to work with local, state, regional, and national authorities in developing a community health information network that will be tested in the rural managed care networks designated by the West Virginia Rural Health Networking Project and will include a database design with the capability of incorporating outcomes criteria, b) the utilization of focus groups to determine perceptions, attitudes, and needs of rural physicians and to test the hypotheses generated by these focus groups through the utilization of a survey of a random sample of primary care practitioners within the three networks identified in the Rural Health Networking Project, c) review and subsequent adoption, adaptation, or development of patient survey instruments by an interdisciplinary team, d) continuing education of rural-based field professors regarding principles of managed care, e) generation of a quarterly Rural Managed Care Demonstration Center newsletter and quarterly meetings with interested researchers from all health sciences centers within the state to facilitate communication and generate ideas for research, f) facilitation of the development of an ombudsman program utilizing significant community input within a minimum of one of the three identified rural networks.
