The Rural Alabama Health Alliance

mentioned earlier, is one of the most extensive collaborative efforts among rural providers in this study. It was established in the early 1990s with the initial objective of incorporating a rural component into the graduate medical education program. Through RAHA, hospitals and physicians have built channels for enhanced communication, information sharing, and joint projects. Some RAHA providers have formed a network to bid on a capitated

Medicaid maternity contract. One respondent noted that an advantage of RAHA is that providers come together as peers, which is less threatening than the networks developed by urban systems that seek to enlist rural providers chiefly to expand their own market areas. RAHA has also received a grant for telemedicine activities, which it is in the process of implementing.