The pivotal role of the academic health center.

Academic health centers (AHCs) now play major roles in the development, adoption, and evaluation of medical technologies; the provision of advice to other entities involved in medical innovation; and the education of current and future practitioners. However, recent and potential health care reform initiatives could make it increasingly difficult for AHCs to continue to play their historical roles in medical innovation. Policymakers are examining specific options that would explicitly cover the cost of some of these services but could take away some of the autonomy AHCs have enjoyed and could change the role of AHCs in technological innovation.

QMHC interview: Robert M. Heyssel, M.D.. Interview by Marie E. Sinioris.

In 1991, US News and World Report rated The Johns Hopkins Hospital as the best hospital in the country. Its survey of physicians revealed that Hopkins is perceived to be at or near the top in 13 of the 15 specialties studied. For the past three years, The Johns Hopkins Health System has been taking a hard look at the nonclinical aspects of health care delivery.

Beyond "health care reform".

The author discusses the need to make corrections in the U.S. health care system, describes the simplistic and money-oriented definition that many persons have of "health care reform," and discusses the issues he thinks will and will not be dealt with in the coming reforms of the health care system.

Competition versus regulation: its effect on hospitals.

While factors other than competition and regulation influence hospital's behavior, these two strategies have dominated the health policy debate. To examine the impact of these two competing strategies on patients and hospitals, the authors examine experiences in Baltimore, which has followed a regulatory strategy since the early 1970s, and Minneapolis/St. Paul, which has pursued a competitive strategy during the same time frame.