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American health care environment in the 1990s

As a result of such financial and personal incentives, more and more physicians are opting for salaried or de facto salaried positions a shift that holds many strategic implications for hospital administrators.

Managed care is evolving within the context of sweeping reimbursement changes that promise to shift the emphasis of governmental and third-party payers away from procedure-oriented and invasive care and back to primary care (Hagland, 1991, p. 21). Resource-based relative value scale (RBRVS) compensation procedures applied to Medicare payments are a driving force for physician-hospital affiliations.

RBRVS is a transitional vehicle to change medical practice away from the traditional production-driven, income-based reward system for physicians and more towards a performance-based, multiple-variant-based system for rewarding behavior (Hagland, 1991, p. 22). The traditional piecework orientation of physician practice is predicted to slowly give way, under reimbursement pressures, to a system in which physicians will be rewarded for optimal utilization rather than maximal utilization. The health care delivery system is being transformed into a true performance-based system.

Treatment emphasis also is changing (Hagland, 1991, p. 22). The emphasis in the past has been on the end-stage treatment of disease, which is extraordinarily expensive care to provide. The future emphasis will be on primary care with a preventive care focus.

The greatest opportunities in health care are projected to be in multi-specialty organizations (Hagland, 1991, p. 22). Hospitals transformed into health care system are multi-specialty entities. Multi-specialty used in this context refers to the broadening of the scope of institutional operations beyond the delivery of acute care to include outpatient services, ambulatory surgery, hospice services, and other compatible services. Affiliation to create health care systems enhances the ability of...

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American health care environment in the 1990s. (2000, January 01). In Retrieved 19:20, November 25, 2015, from
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