title: Physician and health system integration.
abstract: Incentives for vertical integration in the health care industry have led many hospitals to consolidate into health systems and profess a desire for closer alignment with affiliated physicians. In this study of fourteen organized delivery systems and their 11,000 physicians in sixty-nine medical groups, we found that many health systems did not align well with physicians. Even systems ostensibly committed to alignment emphasized structural relationships that did not enhance physician-system alignment and paid inadequate attention to issues of importance to physicians. This gap between the goal and reality of physician-system alignment appears to be the result of systems' responding to a changing mix of policies, not all of which foster integration.
authors.affiliation: University of California Berkeley, School of Public Health, USA.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Budetti
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Shortell
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.forename: Jeffre A
authors.initials: JA
authors.lastname: Alexander
authors.forename: Lawton R
authors.initials: LR
authors.lastname: Burns
authors.forename: Robin R
authors.initials: RR
authors.lastname: Gillies
authors.forename: Howard
authors.initials: H
authors.lastname: Zuckerman
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D004465:Economic Competition; D006123:Group Practice; D006302:Health Services Research; D018578:Hospital-Physician Relations; D016134:Organizational Policy; D017149:Private Sector; D017150:Public Sector; D011787:Quality of Health Care; D014481:United States