Rural provider participation in ACOs will require collaboration
among rural providers and with larger, often urban, health care systems. Rural
providers should strengthen their negotiation capacities by developing rural
provider networks, understanding large health system motivations, and adopting
best practices in clinical management. Rural communities should generate
programs that motivate their populations to achieve and maintain optimum
health status. Policy makers should develop rural-relevant ACO-performance
measures and provide necessary technical assistance to rural providers and
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