ABSTRACT
A practice is part of the whole organized approach to the emerging marketplace, and the physician is part of the practice. But the entire enterprise has to exist as a part of something that can actually contract with managed care organizations and with things that are in place, being developed and being conceived under organizations that will use tools like accountable care organizations (ACOs) and insurance exchanges. These are taking forms that are not unlike the subcapitated contracts that most institutions played with in decades past. What is the same seems obvious; what is different is that the physicians are mostly “in-house,” and there are better management systems in the provider environment.
