Managed Care, Market Stages, and Integrated Delivery Systems: Is There a Relationship?

Lawton R. Burns, Gloria J. Bazzoli, Linda Dynan, Douglas R. Wholey

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


This DataWatch evaluates four-stage models of market evolution developed initially by the University HealthSystem Consortium (UHC). Such models suggest that increasing health maintenance organization (HMO) penetration is linked with increases in hospital consolidation and vertical integration between physicians and hospitals. These claims are tested using national data for 1992-1995. Results suggest that such models accurately classify the markets of UHC member hospitals according to their levels of HMO penetration only. Moreover, they do not discern evolutionary stages of market development and may not be generalizable to the markets of non-UHC member hospitals. Researchers and policymakers should exercise caution in applying such models.

Original languageEnglish (US)
Pages (from-to)204-218
Number of pages15
JournalHealth Affairs
Issue number6
StatePublished - 1997
Externally publishedYes


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