Introduction

Hospitals and physicians are revisiting old models and creating new ones for hospital and physician working relationships. Hospitals that abandoned the physician employment frame work just two years ago are re-establishing new physician staffing and relationship models. While independent physician groups have been seeking new types of affiliations with hospitals, hospital organizations, both not for profit and for profit entities, have the need to resurrect the old integrated delivery systems to address the growing employer influence on local healthcare markets. While the old memories of poor models still remain after a decade, hospitals and physicians have real incentives to work together in capturing the competitive healthcare dollar. In this paper, we will investigate the different incentives that exist today for both hospitals and physicians and provide a new model for hospital/physician organizations to not only co-exist but to meet the market expectations of a quality, integrated delivery system. While there are risks in any new strategy, there are even greater risks for hospitals and physician groups that ignore the current healthcare market movements and relationship formation. Long term physician, hospital and ancillary provider relationships are currently being formed to protect and improve local healthcare market share.