Indeed, even the questions are unclear. No one knows for sure where we will end up. There is no national consensus, no guarantee of long-term success. The issues are control, financial responsibility, ego, power, fear, greed and survival. Business people are good at dealing with issues like this.
Hospital people are relatively comfortable with it.
Doctors abhor it, and physician leadership is opinionated but, particularly in smaller communities, largely untrained and inexperienced. Doctors like precise questions and answers. In this arena, there are none. Solutions are local, not universal, and are in constant flux. Primary care physicians tend to look for more global, community-wide solutions and may see institutional fixes as obstacles to such goals.