In 1982, Starr predicted that relationships between physicians and organizations, including insurers, health systems, and hospitals, would challenge the medical profession’s autonomy, authority, and ability to self-regulate.1 In the intervening years, major growth and consolidation have occurred in nonprofit and investor-owned insurance entities, health systems, and physician practices. While tensions and challenges have coursed through all these relationships, among the most contentious have been relationships between those who provide care, such as physicians and hospitals, and those who pay for care, such as managed care organizations and Medicare.
Sandy LG, Pham HH, Levine S. Building Trust Between Physicians, Hospitals, and Payers: A Renewed Opportunity for Transforming US Health Care. JAMA. 2019;321(10):933–934. doi:10.1001/jama.2018.19357
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