Motives for health plan-academic health center relationships: journal review of the first quarter century.

Motives for health plan (HP)-academic health center (AHC) relationships, including both deterrents and inducements, are explored through a review of 153 articles, published from 1970 through 1997, in academic and health care industry journals about HP-AHC relationships. Every article that met inclusion criteria was coded for year, journal, author, audience, type of article, organization of focus, purposes, priorities, affiliation motives, and issues. Peak years were 1973 (the passage of HMO legislation) and the most recent years from 1994 through 1997. The motives to affiliate were found to be different for AHCs and HPs (e.g., physician attitudes, a deterrent for AHCs and inducement for HPs; resources, a deterrent for HPs and inducement for AHCs). Increases in size of HPs and decreases in political power of AHCs have resulted in changes to motives to form relationships. Motives must be acknowledged to move from competitive to collaborative relationships.