TY - CHAP M1 - Book, Section TI - Hospital Diversification, Restructuring, and Integration A1 - Burns, Lawton Robert PY - 2021 T2 - The U.S. Healthcare Ecosystem: Payers, Providers, Producers AB - Chapter 11 described the loose, but nevertheless complex relationship between the hospital and the physicians on its medical staff. Healthcare delivery by hospitals and physicians has grown more intertwined over the past 4 decades. Much of this has been spurred by federal government efforts to control rising healthcare costs, which relied on regulatory approaches in the 1970s (eg, certificate of need legislation), budgetary remedies (eg, diagnosis-related groups [DRGs] and the Inpatient Prospective Payment System [IPPS]) in the 1980s, and an increasingly diverse and complex reimbursement environment for Medicare and Medicaid patients. Federal efforts were supplemented by private sector efforts in the form of “managed care.” Most of these efforts were directed at the largest destination of healthcare spending—the hospital (40% of national health expenditures in 1980). SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1180253257 ER -