"CO-OPs are likely to face major challenges ... as they prepare for open enrollment in October 2013. On top of the federal funding they have already obtained, CO-OPs will need significant private support to be financially viable.... CO-OPs will need to set their initial premium rates without the historical claims or utilization data on which those rates are usually based.... Some of these challenges in providing care -- such as having an integrated network of high-quality providers -- may be magnified if a CO-OP tries to operate in more rural or medically underserved communities."  MORE >>