Physician-system alignment - Introductory overview

The papers in this Special Supplement are based on research funded by the p articipating members of the joint Center for Health Management Research (CH MR) and Center for Organized Delivery Systems (CODS), and supported by the National Science Foundation under its industry-University Cooperative Resea rch Center Program. This 3-year research initiative from 1996 through 1999 involved 69 physician organizations (primarily organized medical groups as opposed to IPAs) associated with 14 organized delivery systems. The groups ranged in size from three to 958 with an average size of 76.4 and a median size of 25.0, Comparisons of the study groups with United States physician groups overall are shown in Table 1, The study groups are larger and more l ikely to be multispecialty than all groups in the United States. The organized delivery systems range in size from one hospital to 80 hospit als with an average of 21 hospitals per system and a median of 11 hospitals per system. They average 4.6 affiliated medical groups with a range from o ne to 23. The organized delivery systems range in total revenues in 1998 fr om $340 million to $6.2 billion with an average of $2.1 billion. All the st udy systems are not-for-profit. Most are located in single market areas, bu t several are located in multiple markets. For the most part, they represen t some of the larger most experienced organized delivery systems in the cou ntry. Among the primary objectives of the study was to identify the factors most strongly associated with physician alignment with the health care system an d the consequences for the implementation of evidence-based care management practices. The study was also designed to identify the barriers and facili tators to achieving such alignment and its consequences.