Document Type

Working Paper

Publication Date



Disability and Aging, Cutler Institute, USM Aging Initiative, Policy


Federal and state policy makers, consumers, health plans, providers, and other stakeholders are interested in the benefits and disadvantages of integrating acute and long term care financing in rural areas. To date, experience with integrated financing is limited and is based largely in urban areas. This paper reviews current research and experience and identifies key policy and program considerations for integrated financing in rural areas.


Working Paper No. 21

The conclusions and opinions expressed in the paper are the authors’ and no endorsement by the University of Southern Maine or the funding source is intended or should be inferred. Working Paper #21, Financing and Payment Issues in Rural Long Term Integration describes the policy and research background, methods and findings in depth, and is available from the Maine Rural Health Research Center. Copies of Working Paper #21 are available at our web site (

Funding Organization

This study was funded by a grant from the Federal Office of Rural Health Policy, Health Resources and Services Administration, DHHS (Cooperative Agreement # CSUR00003-04).



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