The blending of competitive and regulatory strategies: a second opinion.

A comparison of the 10 states that as of 30 June 1994 witnessed the highest and lowest percent of health maintenance organization market penetration, and the findings reported in the Dartmouth Atlas of Health Care in the United States, both illustrate dramatic differences among the various states in the distribution, utilization, and cost of hospital and other health services. This article thereafter focuses on the implications of these findings in the context of the states eventually blending competitive and regulatory strategies to constrain hospital expenditures-a conceptual framework that is consistent with Americans being advocates of pluralism when organizing and financing their health care system.