The Nebraska Center for Rural Health Research (NCRHR) will establish a Program for Rural Demonstration Activities. The Program would be responsible for implementing demonstrations of activities designed to improve the practice of managed care in the rural communities in Nebraska and Iowa. A consortium of the NCRHR, the University of Iowa Graduate Program in Hospital and Health Administration/Center for Health Services Research, the Nebraska Office of Rural Health, and the Iowa Office of Rural Health will have governing responsibility for designing and implementing the specific demonstrations carried out in this AHCPR- sponsored project. Rural communities in each state will be targeted for demonstration activities based on these criteria: 1) existing activities indicating a receptivity to change; 2) inclusion of minority populations; 3) need to address particular health care problems; 4) need to overcome barriers to adequate health care; and 5) ability to integrate with other programs. Within each area, the demonstration activates will target primary care practitioners and their practices. Data will be collected in both states using the same sources and programmed for comparative analysis. After completing demonstrations in each state, demonstrations will be implemented on the Nebraska-Iowa border, at which time two investigators from Kansas State University and the University of Kansas School of Medicine - Wichita will be added to the project team.