Eleanor Roosevelt once said, "It's better to light a candle than to curse the darkness." This can be taken as advice to rural physicians looking at the new Medicare opportunities outlined in the Balanced Budget Act of 1997 focus upon the opportunities available rather than struggle with the poor reimbursement and program design of traditional Medicare.

The opportunity for the growth and development of provider-sponsored organizations (PSOs) helps the federal government work with physicians and hospitals to share the risk of managing the health care of Medicare eligible baby boomers. In this monograph, we will focus on the PSO as a provider-driven enterprise developing from the government's desire to partner with physicians and hospitals, especially in rural America, to offer managed health care options to Medicare beneficiaries. We will focus on how physicians and hospitals need to collaborate to work successfully under the new Medicare program to offer local options to Medicare beneficiaries in every community throughout the country.