Something Old, Something New: Recent Developments in Hospital–Physician Relationships
Article first published online: 21 FEB 2003
Health Services Research
Volume 38, Issue 1p2, pages 471–488, February 2003
How to Cite
Lake, T., Devers, K., Brewster, L. and Casalino, L. (2003), Something Old, Something New: Recent Developments in Hospital–Physician Relationships. Health Services Research, 38: 471–488. doi: 10.1111/1475-6773.00125
- Issue published online: 21 FEB 2003
- Article first published online: 21 FEB 2003
- integrated delivery system;
- managed care
Objective. To describe recent developments in hospital–physician relationships in 12 metropolitan areas.
Methods. We analyze qualitative data from a third round of biannual site visit interviews conducted in 12 randomly selected metropolitan areas from 1996 to 2001. The study interviewed 895 respondents during the third round of site visits, conducted in 2000 and 2001.
Principal Findings. As HMO enrollment and capitation contracting has failed to grow in local markets, hospital executives have returned to a strategic focus on improving relationships with specialists in pursuit of fee-for-service revenue. Yet, 65 percent of hospitals interviewed in 2000 and 2001 continued to own primary care physician practices, with ownership more prevalent in highly concentrated hospital markets. A majority (55 percent) of hospitals have decreased the size of these practices in the past two years.
Conclusions. Interest in forming integrated delivery systems has waned. The potential for quality improvement through these organizations systems—by emphasizing primary care and coordinating hospital and physician services—has not been realized. The new emphasis on hospital–specialist partnerships may improve the financial status of hospitals and participating specialists in local markets, and may improve quality of care in selected service areas, but it may also increase health care costs incurred by employers and consumers.