Health care delivery systems in review

The focus in the HMO and PPO industry has shifted from financial difficulties to accountability. Quality tracking and utilization review systems are being implemented on a local and state level, while on the national level, the JCAHO has devised applicable criteria. The relationship between physicians and HMOs continues to be tenuous. However, in plans where physicians play a greater role in decision making, the relationship improves. Changes to the HMO Act may mean lessened federal control over HMOs, while the extent of state legislation increases.