Physician and health system integration

Peter P. Budetti, Stephen M. Shortell, Teresa M. Waters, Jeffrey A. Alexander, Lawton R. Burns, Robin R. Gillies, Howard Zuckerman

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


Incentives for vertical integration in the health care industry have led many hospitals to consolidate into health systems and profess a desire for closer alignment with affiliated physicians. In this study of fourteen organized delivery systems and their 11,000 physicians in sixty-nine medical groups, we found that many health systems did not align well with physicians. Even sys-tems ostensibly committed to alignment emphasized structural relationships that did not enhance physician-system alignment and paid inadequate attention to issues of importance to physicians. This gap between the goal and reality of physician-system alignment appears to be the result of systems' responding to a changing mix of policies, not all of which foster integration.

Original languageEnglish
Pages (from-to)203-210
Number of pages8
JournalHealth Affairs
Issue number1
StatePublished - 2002

ASJC Scopus subject areas

  • General Medicine


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