Models for integrating and managing acute and long-term care services in rural areas

States and the federal government are searching for new managed-care strategies, such as capitated financing and coordinated case management, that integrate the financing and delivery of primary, acute, and long-term care sen,ices. For rural communities, the development of organizational and delivery systems, which better integrate and manage primary, acute, and long-term care services, may help address long-standing problems of limited access to long-term care services. This article discusses the concept of integrated acute (medical) and long-term care sen,ice networks; model programs; challenges that health cure providers, state policy makers, and others have faced in developing these new integrated structures; and the future of service-integration and coordination approaches in rural areas.