The new environment for rural HMOs

The difficulty of acquiring the requisite initial financing has constituted a historical impediment to the development of rural HMOs. The recent elimination of federal fund for HMO development will certainly make it more difficult, although not impossible, for HMOs indigenous to rural areas to form. As a result, it seems probable that the future growth of prepaid care in rural areas will occur largely as a result of the expansion of existing rural- or urban-based plans, rather than through the formation of small rural-based organizations.