1. What were the historic developments leading to modern group practices? How may the recent passage of health care reform legislation affect group practices in the future? Please take 1-2 significant developments such as accountable care organizations (ACOs), medical group homes, etc. and relate them to the future of physician group practices.

The evolution of Medical Group practice began with Mayo Clinic during World War I. There is no exact date when this started but has become a very import aspect of the health care delivery system. Organizations such as the American College of Medical Patrice Executives (ACMPE), Medical Group Management Association (MGMA) and American College of Physician Executive (ACPE) were established in support of group practices.
Group Practice defined by the American Medical Association is “the provision of health care services by a group of at least three licensed physicians engaged in a formally organized and legally recognized entity; sharing equipment, facilities, common records, and personnel involved in both patient care business and management”. In the early days the AMA was very concerned about group practices and the challenges they would likely to encounter. Some of these concerns included the relationship between employers & employees, prepayment of medical services which could potentially threaten the integrity of the physician patient relationship. Another concern was the involvement by group practices in consumer controlled health care cooperatives.

There were many discussions among leaders of the AMA who then decided to rearrange things within the organizational structure by forming a group practice committee to communicate with other members of the organization with any issues that are related to this topic. This led them to recognize that there are numerous factors that would influence the development of group