The papers in this volume grew out of a series of informal discussions and activities going back to June 1981, when the Institute of Medicine brought together a diverse group of knowledgeable persons for a one-day workshop titled "Trends in For-Profit Health Care." The workshop was organized by Carleton Evans, M.D., then Director of the Division of Health Care Services at the Institute, and was supported by National Academy of Sciences' program initiation funds. The workshop and the subsequent discussions resulted in a plan for a two-year study of physician involvement in for-profit enterprise in health care, to be completed at the end of 1984. A preliminary phase of the Institute's study, during which this collection of papers was prepared, was supported by the Hospital Corporation of America and the Commonwealth Fund.

We would like to thank the following members of the Institute's Board on Health Care Services and the Institute's Council for reviewing various of the papers published herein: Linda Aiken, Richard Egdahl, Charles Lewis, Peter Libassi, David Mechanic, Howard Newman, and Sam Shapiro.

KARL D. YORDY, DIRECTOR

DIVISION OF HEALTH CARE SERVICES