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Previous Volume 342:1064-1068 April 6, 2000 Number 14

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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The reports of my death are greatly exaggerated.

—Mark Twain

On September 2, 1999, the California Medical Association released a highly publicized report entitled, "The Coming Medical Group Failure Epidemic."¹ The report begins, "Mounting evidence collected by the California Medical Association now points to the imminent collapse of a key element in the state's health care delivery sys-tem . . . with as many as 90 percent of . . . phy- sician organizations in the state poised for bankruptcy or closure."

In 1998, the financial collapse of two large physician-practice–management companies, MedPartners and FPA Medical Management, left thousands of . . . [Full Text of this Article]

The Group-Contracting Model

Are California's Physician Groups Failing?

Why Are Physician Groups in Trouble?

Reduced Payments from HMOs

Reduced Revenues from Hospital Risk Pools

Increased Expenses

            Oral Medications

            Injectable Drugs

            Specialty Care

Poor Management

Impact on Physicians and Patients

What Might Happen Next?

The Future for Physician Groups

The Future for HMOs

The Future for Large Employers

Conclusions

References

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