Both physician practices and hospitals are stand-alone. Primary care practices are organized into group practices with primary care capitation. Appearance of integration by groups without walls. Primary care widely capitated. Hospitals and MSOs actively buy primary care groups to ensure hospital admissions and referrals to specialists.
Focused care is emphasized.
Merger of large HMOs. Hospitals and large physician groups merge regionally. Specialty care is capitated. Point of service plans are losing leaders for marketing by the HMOs to entice subscribers. Tertiary services are consolidated regionally.