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date: 10 December 2019

Abstract and Keywords

This chapter explores legal and policy issues pertinent to the relationship between hospitals and physicians, both traditionally and in the context of the Patient Protection and Affordable Care Act (PPACA). It begins with background on the origin and evolution of the hospital-physician relationship and how it has been shaped by issues and policies such as health insurance, health reform, the changing workforce, and markets and competition. It then considers two regulatory initiatives in healthcare reimbursement and their impact on the hospital-physician relationship: Medicare’s prospective payment system and bundled payment. It also discusses the role of medical staff in doctors’ legal relationship with hospitals, and how hospitals have been forced to pursue strategies such as joint ventures and co-management due to competition and federal policy. The chapter concludes with an assessment of PPACA provisions that expand the role of hospitals and physicians in the federal government’s campaign to improve population health.

Keywords: hospitals, physicians, Patient Protection and Affordable Care Act, hospital-physician relationship, health insurance, health reform, healthcare reimbursement, prospective payment system, bundled payment, medical staff organization

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