Center for Studying Health System Change

Providing Insights that Contribute to Better Health Policy

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Insurance Coverage & Costs Access to Care Quality & Care Delivery Health Care Markets Employers/Consumers Health Plans Hospitals Physicians Issue Briefs Data Bulletins Research Briefs Policy Analyses Community Reports Journal Articles Other Publications Surveys Site Visits Design and Methods Data Files


 
 

Linda T. Kohn

 
     
 
 

Health System Change in Seattle, Washington

August 1997
Case Study
 
 

Health System Change in Syracuse, New York

July 1997
Case Study
 
 

Health System Change in Lansing, Michigan

August 1997
Case Study
 
 

Health System Change in Orange County, California

September 1997
Case Study
 
 

Health System Change in Boston, Massachusetts

June 1997
Case Study
 
 

Health System Change in Cleveland, Ohio

May 1997
Case Study
 
 

Do HMOs Make a Difference?

Winter 1999/2000
Inquiry
 
 

Association Leaders Speak Out on Health System Change

January/February 1997
Health Affairs
 
 

Snapshots of Change in Fifteen Communities:

Summer 1996
Health Affairs
 
 

Snapshots of Change in Fifteen Communities:

Summer 1996
Health Affairs
 
 

Snapshots of Change in Fifteen Communities:

Summer 1996
Health Affairs
 
 

Snapshots of Change in Fifteen Communities:

Summer 1996
Health Affairs
 
 

Health System Change in Little Rock, Arkansas

July 1997
Case Study
 
 

Health System Change in Miami, Florida

June 1997
Case Study
 
 

Health System Change in Newark, New Jersey

September 1997
Case Study
 
 

Health System Change in Greenville, South Carolina

September 1997
Case Study
 
 

Health System Change in Indianapolis, Indiana

September 1997
Case Study
 
 

Health System Change in Twelve Communities

September 1997
Compilation of 1996-97 Site Visits
 
 

Collaboration and Competition Coexist

Fall 1998
Community Report No. 01
 
 

Health System Change in Phoenix, Arizona

September 1997
Case Study
 
     

Monitoring Market Change: Findings from the Community Tracking Study:

Organizing and Managing Care in a Changing Health System

April 2000
Health Services Research, vol.35, no.1, Part 1 (April 2000): 37-52
Linda T. Kohn

great deal of experimentation and apparent duplication exist in efforts to develop programs to influence physician practice patterns. Based on interviews with providers and other health care leaders in 12 communities as part of the Community Tracking Study, the authors found that responsibility for managing care is being contested by health plans, medical groups and hospitals, as each seeks to accrue the savings that can result from more efficient delivery of care. To manage the financial and clinical risk, providers are aggressively consolidating and reorganizing. Most significant is the rapid formation of intermediate organizations for contracting with managed care organizations. Despite the profound effect that managed care has on how providers are organized, it seems to have only a modest effect on how health care organizations deliver medical care. Rather than improving the efficiency of health care organizations, provider efforts to build large systems and become indispensable to health plans are exacerbating problems of excess capacity.

For a full copy please visit Health Services Research.

 

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