With the rapid growth of managed care and the demise of comprehensivehealth care reform, most academic medical centers now seem torecognize that they can no longer operate as specialty-driveninstitutions largely divorced from trends that favor lower costs,less hospitalization, and more primary care. Many centers areresponding to these trends by striving to build or join networksof providers in the community. They are greatly expanding theircapacity to deliver primary care and teach medical studentsand residents at ambulatory care training sites. Some centersare also integrating their business and clinical operations,streamlining their management structures, . . . [Full Text of this Article]
Threats to Economic Foundations
Reinventing Structures
New Clinical Organizations
Structures of Governance
Building Networks of Providers
Acquiring Physicians' Practices
Seeking Ties That Bind
Conclusions
References
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