title: Update on the nation's health care system: 1997-1999.
abstract: A major component of the Community Tracking Study is biennial site visits to twelve communities randomly selected to be representative of metropolitan areas. In the second round of visits, conducted in 1998 and 1999, we 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.
authors.affiliation: Center for Studying Health System Change (HSC), Washington, D.C., USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Lesser
authors.forename: P B
authors.initials: PB
authors.lastname: Ginsburg
mesh_terms: D001294:Attitude to Health; D002204:Capitation Fee; D003153:Community Health Services / Q000458:organization & administration / Q000639:trends; D019033:Delivery of Health Care, Integrated / Q000639:trends; D017598:Efficiency, Organizational; D019981:Health Care Sector / Q000458:organization & administration / Q000639:trends*; D006297:Health Services Accessibility / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D008329:Managed Care Programs / Q000706:statistics & numerical data / Q000639:trends; D009096:Multi-Institutional Systems / Q000639:trends; D014481:United States