Accountable Care Organizations require a close alignment of physicians and their groups with doctors so it appears this is what the goal here is, along with negotiated new contract provisions while they are at it. Something along this line is being tried in California and has ended up in court. 
City of Hope Files Lawsuit Against Their Own Doctors – Wants MDs Join For Profit Medical Group & Terminating Nearly All Physician Research Current Contracts
The whole idea here is to lower costs and rewards will be given for those who keep the cost down and focus on preventive medicine. Also keeping down inpatient admissions figure n here too. Some doctors in the entire process stand to be laid off as well. BD
New York City's public hospital system is bracing for federal health reform by changing how it contracts with the doctors that work at its hospitals. The new contracting strategy is part of a broad restructuring announced in May to save the New York City Health and Hospitals Corp. millions of dollars, and to position the agency in a post-health care reform world.
At stake are some $857 million in contracts in HHC's 2011 fiscal year. HHC said in May it would restructure its affiliation agreements; the contract consolidation is part of that strategy. The system is also cutting 6%, or $51.5 million, from its affiliation costs by laying off doctors and taking other steps.
The system currently secures physician services through eight contracts with medical schools or large group practices. That volume complicates HHC's ability to function as an integrated delivery system and deliver more coordinated care-management in the reform era.
The change in affiliation contracts is one step HHC is taking toward becoming what is called an accountable care organization, a new type of arrangement under the federal health care reform law that requires close alignment of a physician work force with hospitals.
These accountable care organizations, large collectives of doctors, hospitals and outpatient facilities, will play a greater role in lowering costs and improving the quality of care for their Medicare patients. In exchange, they get higher Medicare reimbursement. The organizations are intended to reward providers that shift their focus to preventive care and lessen the need for expensive inpatient procedures.
Public hospital system yanks doctor contracts - Crain's New York Business
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