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Administration ambulatory American Medical Association analysis average behavior benefits billion Burlington Industries changes charges clinical companies cost containment cost-benefit analysis costs of medical decisions delivery diagnosis-related group disease doctor-patient relationship doctors dollars economic effect efficiency efforts Eisenberg elderly employees England Journal etal ethical example expensive federal Figure funds growth health care costs Health Care Financing health care system health insurance health maintenance organizations HMOs ical incentives increase intensive care unit Internal Medicine interventions investor-owned hospitals Journal of Medicine laboratory tests limit major McPhee Medicaid medical cost Medical Education medical practice medical services medical technology Medicare myocardial infarction National Health Expenditures nonprofit nursing home organizations outcome outpatient patients percent persons physicians population problems procedures prospective payment providers rates rationing reduce reimbursement residents result Schroeder sician social strategies studies surgery tion utilization