| Insurers |
Medicaid Medicare
Purchasing alliances |
Moving to managed care
Reimbursement restrictions
Capitation/bundling of services |
| Employers |
Employer coalitions |
Negotiating directly with providers
Restrict covered services |
| Government |
Entitlement programs
Regulatory programs |
Funding and eligibility restrictions
Added administrative costs
(i.e. HIPAA*)
Added reporting burden |
| Competition |
Networks
Private Sector |
Market share diminishing
Competition for staff/patients |
| Managed Care |
HMO
PPO |
Funding restrictions
Gatekeeper
Limitation on services covered |
