Health System Change in 1997

July/August 1998
Health Affairs , vol.17, no.4 (July/August 1998): 165-169
Paul B. Ginsburg

he year 1997 was important in the evolution and financing of health care delivery. There were two broad key developments. First, consumers demanded a greater choice of providers, and the market has responded. Second, public policy activity has reemerged as legislators took important steps to expand health insurance coverage and regulate health care markets. Specifically: demand for choice has had profound implications for the organization of health care delivery and for the dynamics between plans and physicians; consumers and physicians have pressed elected state and local representatives to restrict some managed care practices; the pace of hospital consolidation declined in 1997 after years of increases; and health care leaders have developed an increased sense of urgency about addressing the problem of uneven quality of care.

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