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Published at www.nejm.org October 28, 2009 (10.1056/NEJMp0909327)

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With discussions about U.S. health care reform focused heavily on insurance reforms, relatively little attention has been paid to the delivery-system reforms that will be required to improve the quality and coordination of health care and slow the growth of spending. The "patient-centered medical home" (PCMH) and the "accountable care organization" (ACO) are two widely discussed models for delivery-system reform that take complementary approaches to achieving these goals. The PCMH model emphasizes the creation of a strong primary care foundation for the health care system, and the ACO model emphasizes the alignment of incentives and accountability for providers across the . . . [Full Text of this Article]

Source Information

From the Department of Family and Community Medicine, University of California, San Francisco, San Francisco (D.R.R.); the School of Public Health, University of California, Berkeley (S.M.S.); and the Dartmouth Institute for Health Policy and Clinical Practice and Dartmouth Medical School, Lebanon, NH (E.S.F.). The authors participated in the meeting along with Melinda Abrams, M.S., Michael S. Barr, M.D., M.B.A., Robert Berenson, M.D., Karen Davis, Ph.D., Kevin Grumbach, M.D., David Meyers, M.D., Hoangmai Pham, M.D., M.P.H., Robert L. Phillips, Jr., M.D., M.S.P.H., and Dana Gelb Safran, Sc.D. The consensus that emerged from the discussion and that is summarized in this article should not be taken to be the perspective of any specific individual or organization.

This article (10.1056/NEJMp0909327) was published on October 28, 2009, at NEJM.org.

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