Challenges for physician executives in the millennium marketplace

There will be fundamental change in the Millennium, but not enacted in Washington, D.C. American health care is entering the "post-Managed Care" era in which payers, providers, plans, and patients reconstruct a new, more efficient, and, ultimately, more satisfying health care delivery system. The Millennium landscape of this evolving marketplace will be characterized by the following trends: (1) The "Age Wave" will boost demand: (2) There will be a push from technology; (3) Public/private health reform will be enacted; (4) Employers will use clout; (5) Direct provider contracting will prevail; (6) Government will regulate managed care organizations; (7) Managed Medicare/Medicaid will be restructured; (8) There will be a health plan shakeout; (9) Providers will "push back"; (10) Doctors will get organized; (11) Providers will assume risk; (12) "Report cards" will be widespread; (13) Managing clinical performance will be the core business of providers; and (14) Health consumers will be informed and Internet savvy.