title: Perspective from a hotbed of managed care.
abstract: An environmental assessment of the current healthcare market in the United States shows four stages of evolution: (1) the unstructured stage, (2) the loose framework, (3) consolidation, and (4) managed competition. Recognition of these stages should help in the development of strategies for the future. After determining the existing stage of the health-care market in a particular geographic area, clinical endocrinologists can compose a vision statement, develop goals and objectives, and formulate strategies to achieve the established goals. For example, one strategy is to join a managed-care plan. Some practical business advice about assuming risk (responsibility) for various health-care services is provided, and the concept of disease-specific capitation is discussed. Health-care reform is likely to proceed regardless of what the federal government does. In the managed-care environment, the most successful physician participants will be those who are thoroughly informed.
authors.affiliation: Baptist & Physicians Integrated Delivery System, Central Services Bureau, Inc., Memphis, TN 38138, USA.
authors.forename: N
authors.initials: N
authors.lastname: Kaminsky