How does administrative complexity affect a large physician organization? The researchers examinined administrative complexity from the perspective of a large physicians organization, the Massachusetts General Physicians Organization (MGPO). They addressed the following research questions: (1) what is the magnitude of the burden and growth trajectory of administrative complexity on physicians; (2) which components account for the greatest proportion of the burden, and which are the most amenable to change; (3) how is administrative burden reflected; (4) who currently bears the burden and how can that burden be made more transparent; (5) what components of complexity do and do not offer value; (6) what is the impact of quality, particularly pay for performance contracting; (7) which components are best addressed by information technology and what has been the impact of HIPAA standards; (8) what are the potential savings through simplification and standardized processes; and (9) what processes will facilitate addressing complexity at the physician services level? The objective of the project was to examine why market forces have increased, rather than mitigated, administrative complexity and examine whether non-market-based solutions may offer opportunities for addressing the problem.