Tracking the changing provider landscape: Implications for health policy and practice

Throughout the 1990s health care providers were interested in developing or ganized delivery systems. However, industry observers have increasingly que stioned the sense of these efforts. Using an established taxonomy of health networks and systems, we examined whether there was a nationwide trend awa y from the vertical and horizontal arrangements that serve as the backbone to organized delivery systems. Studying 1994-1998, we found that both healt h networks and systems became less centralized in their hospital services, physician arrangements, and insurance product development. We did not find a general pathway to disintegration but instead found considerable experime ntation in organizational form.