ABSTRACT
The simple answer is probably not. The more complete answer is that the physician-hospital organization (PHO) or independent provider association (IPA) or management services organization (MSO) or whatever interim structure that exists now is probably inadequate for the needs of future contracting adventures. If the traditional hospital and medical staff structure worked, most hospitals would never have capitalized these alternative forms of hospital-physician partnerships. The traditional medical staff did not fulfill the need to be able to contract with the managed care forms emerging in the 1980s and 1990s, and the present partnerships won’t handle the population management* challenges of the present and the near term. This book will cover these forms, but only because they are part of the reorganization process, and they are not going away soon. They may not be structured correctly for the future, but the medical staff is not going to disappear, and neither are the networks that have been created around them. Figure 3.1 displays the various types of physician relationships that a hospital may have to organize in order to respond to a contracting opportunity (or threat). The typical contracting group is an IPA or a PHO, but that may only contain part of the medical staff, and it might
also include others in the community that are not within the traditional medical staff. Contracted and employed physicians are always in the contracting group.*
Figure 3.2 is a depiction of a “universe” of providers that reflects the challenge that a hospital might have with delivering care to a patient population when the basic physician complement is arrayed in a number of different relationships, not all of them supportive.
