title: American medical home runs.
abstract: Four primary care sites in the United States constitute "medical home runs" because their patients incur 15-20 percent less (risk-adjusted) total health care spending per year than patients treated by regional peers, without evidence of reduced quality. The sites achieved this result in a U.S. payment environment that usually penalizes physicians who invest to prevent costly near-term health crises. If the ingredients and accomplishments of these four sites spread, under- and uninsured lower-income Americans could be fully covered in the foreseeable future without increased health spending or lower quality of care. In exchange, sponsors of health benefits would gladly support additional primary care physician payment.
authors.affiliation: Pacific Business Group on Health in San Francisco, California, USA. arnold.milstein@mercer.com
authors.forename: Arnold
authors.initials: A
authors.lastname: Milstein
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gilbertson
mesh_terms: D002908:Chronic Disease / Q000191:economics / Q000628:therapy; D003363:Cost Control / Q000379:methods; D017598:Efficiency, Organizational; D005102:Health Expenditures; D006801:Humans; D009936:Organizational Innovation; D011320:Primary Health Care / Q000191:economics* / Q000458:organization & administration; D011787:Quality of Health Care; D014481:United States