In response to managed care pressures and imminent legislative reforms
, provider organizations across the United States are coming together
to form organized or integrated delivery systems. This paper describes
various approaches to developing such systems and, drawing on ongoing
research, examines what is known about the performance of such system
s, the barriers they face, and the key factors likely to be associated
with their success. The paper also addresses important policy questio
ns related to the extent to which organized delivery systems should be
actively encouraged by health reform legislation and how such systems
should be held accountable.