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The National Health Policy Forum sponsored a site visit to St. Louis, Missouri, on April 3-5, 2007, to consider the relationships between hospitals and physicians—and the degree of alignment in their financial, organizational, and policy goals—as a foundation for a new round of discussions on how to reform the health care system. St. Louis offered an interesting venue for these investigations because it is home to two major medical schools, three large hospital systems, and a physician community dominated by small practices. Site visit participants were able to converse with community, business, medical school, hospital, and physician leaders to learn more about their various competitive and collaborative activities. How this all plays out for vulnerable populations was also explored.

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