Managed Care and Hospital-Physician Integration. Executive Summary. FinalNarrative Progress Report

摘要

It has long been suggested that the growth of managed care would lead to closerlinkages between hosptials and physicians. The use of capitation in particular has been seen as changing the incentives facing providers and leading to integrated delivery systems that have removed conflicting incentives among providers. Such integration could be structural in the sense of the verticle merging of traditional hospital and physician firms into a common delivery organization. It can also be more informal in the sense of small linkages in management, sharing of information, development of clinical routines, that serve to tie hospitals and physicians more closely together. The specific aims of this study were: (1) to describe the different integrative structures and practices that hospitals and physicians have developed to cope with managed care, and (2) to estimat the impact of managed care on integrative structures and practices developed between hospitals and physicans.