Doctors Health Care System has integrated health networks in three different regions: northern California, southern Florida, and Oklahoma. These three markets have vast regional differences. Because of the increasing penetration of the U.S. health-care market by managed care companies, Doctors Health Care System must create a system that offers continuity of care across the continuum for a set price in order to remain competitive. Its board of directors set the system’s goal as being a leader in developing and maintaining integrated health networks that improve the health status of their communities.

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To meet this goal in the three regions, should the health system’s management structure be decentralized or centralized? What are the advantages and disadvantages of each option?