title: Health planning programs: the past suggests the future.
abstract: Federally supported health systems agencies are a thing of the past. Now is the time to explore some possible changes to the health planning structure instead of accepting the demise. A considerable historical record illustrates achievements and problems as well as opportunities for shaping a continued health planning program, whether under federal or state legislative sanction. The dominant focus of many HSAs was cost control and bed reduction. These strategies did not reflect that reimbursement changes, peer review systems and competitive forces had a more significant impact on bed reduction and cost containment than traditional regulatory planning approaches. In any future reconfiguration, health planning must go beyond its traditional cost control emphasis and assume greater responsibilities for promoting competition in health care. Should HSAs be reorganized under a state setting, they must strive to preserve the principle of local advocacy and not become subservient to a new form of centralized planning control.
mesh_terms: D004465:Economic Competition; D005161:Facility Regulation and Control; D006285:Health Planning; D006307:Health Systems Agencies; D012040:Regional Health Planning / Q000639:trends*; D014481:United States