Abstract
In an era of constraints on public and private sector health care budgets, organizational restructuring of hospital and physician practice, and the shifting of financial risk to patients and providers, rural health professionals and communities are grappling with the issue of how to assure access to a comprehensive and affordable set of health care services. In recent years, rural health providers have turned to the strategy of developing voluntary network relations as an alternative to system or diversification strategies that entail ownership and management by one entity. A systematic analysis of the cooperative efforts of selected providers results in a proposed definition of integrated rural health networks and highlights critical aspects of their formation and development.