In the same way we face major societal challenges in healthcare cost, quality, and access, individual HDOs face equally complex and demanding challenges. The envi- ronment is extremely complex, influenced by constantly shifting political, social, tech- nical, and financial trends. . healthcare provides fragmented services that include simultaneously competitive and cooperative participants. For example, in many hos- pitals the physicians who admit patients function as independent contractors of the hospital and as such are not employees of the hospital. In addition, the range of ser- vices these physicians provide in their private practices may overlap with those offered in the hospital so the incentives.
