title: Creating an effective and efficient publicly sponsored health care delivery system.
abstract: An effective and efficient publicly sponsored health care delivery system can increase access to care, improve health care outcomes, and reduce spending. A publicly sponsored health care delivery system can be created by integrating services that are already federally subsidized: community health centers (CHCs), public and safety-net hospitals, and residency training programs. The Patient Protection and Affordable Care Act includes measures that support primary care generally and CHCs in particular. A publicly sponsored health care delivery system combining primary care based in CHCs with safety-net hospitals and the specialists that serve them could also benefit from incentives in the Patient Protection and Affordable Care Act for the creation of accountable care organizations, and reimbursement based on quality and cost control.
authors.affiliation: UCSF Fresno Department of Family and Community Medicine, Fresno, CA 93701, USA. jzweifler@fresno.ucsf.edu
authors.forename: John
authors.initials: J
authors.lastname: Zweifler
authors.forename: Kris
authors.initials: K
authors.lastname: Prado
authors.forename: Chris
authors.initials: C
authors.lastname: Metchnikoff
mesh_terms: D003151:Community Health Centers / Q000191:economics*; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000191:economics; D017598:Efficiency, Organizational; D005380:Financing, Government; D006297:Health Services Accessibility; D006779:Hospitals, Public / Q000191:economics; D006801:Humans; D007396:Internship and Residency / Q000191:economics; D058991:Patient Protection and Affordable Care Act; D011320:Primary Health Care / Q000191:economics*; D017150:Public Sector / Q000191:economics; D014481:United States