The competitive market: changing medical staff accountability.

Hospital costs are beginning to increase rapidly. The expense-control strategies employed by health insurance carriers, as well as utilization review, managed care, co-insurance, and deductibles have taken affect, and it appears that no further significant cost savings can be achieved. It is likely that new cost-containment strategies of health insurance carriers will include consolidation of hospitals and physicians into a joint program. Such combined programs will be financially driven to encourage price sensitivity through a combination of hospital and physician services. The net effect will be the development of new patterns of medical staff and hospital arrangements requiring greater accountability of hospital governance for both medical and hospital costs.