Integration consternation. The IDS faces an uncertain future.

Abstract

Many healthcare providers across the country are finding themselves in reactive mode: New York City is a case in point. After years of bureaucratic indolence and excess in which the city trailed the rest of the country in reform initiatives, managed care is now taking the entire state by storm. With the passage of the New York Healthcare Reform Act of 1996, the state is in the process of moving from a highly-regulated, prospective payment system to a competitive system of negotiated rates for non-Medicare payors of inpatient care.