Update on the Nationís Health Care System:

Results from Tracking Change in 12 Communities, 1997-1999

November/December 2000
Health Affairs , vol.19, no.6 (November/December 2000): 206-216
Cara S. Lesser, Paul B. Ginsburg


major component of the Community Tracking Study is biennial site visits to 12 communities randomly selected to be representative of metropolitan areas. In the second round of visits, conducted in 1998 and 1999, the authors found an intensification of an earlier trend toward looser forms of managed care to be causing enormous turmoil, as health care organizations stumbled over and often abandoned strategies conceived for more tightly managed care. Communities’ health care systems are not evolving as many anticipated, but rather have focused increasingly on horizontal consolidation and regional scope.

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