Prologue: In anticipation of reforms at either the state or the national level and in response to rising costs, health care organizations are changing rapidly. "Managed care" has taken on new meanings us the lines traditionally separating...
morePrologue: In anticipation of reforms at either the state or the national level and in response to rising costs, health care organizations are changing rapidly. "Managed care" has taken on new meanings us the lines traditionally separating hospitals, physicians, and insurers begin to blur. Policymakers struggle to define this new concept of managed care, sometimes referred to us "integrated service networks" or "organized delivery systems." These entities combine the organization, financing, and delivery of health care in wuys that respond to the demographics and economics that prevail in different regions of the country. Ultimately , the system should provide appropriate care in a seamless continuum that uses limited resources most effectively. The way these new organizational hybrids grow and develop in their early years has important implications for the health and health care of Americans for years to come. In this paper Stephen Shortell and colleagues outline their research on organized delivery systems, describe the barriers such systems face, and raise key policy questions that must be answered.