ABSTRACT
Each of the case studies described above is typical of many health care organizations in the northeastern United States. The reasons each of these three organizations seeks to form or participate in a CHIN varies-from establishing the loyalty of practicing physicians in a community hospital's struggle to survive, through sharing of real-time patient care data in a successful community-wide effort to avoid expensive duplication of services, to driving the transition from a multihospital integrated delivery system to a full-risk accountable health plan. While the need to reduce costs, by taking advantage of economies of scale and prospectively monitoring utilization, is common to all three organizations, selecting the type of CHIN that best fits each scenario, with particular emphasis on aspects of control, is the key success factor.
