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Public Health Reviews

, Volume 32, Issue 1, pp 190–212

First Online: 05 June 2010DOI: 10.1007-BF03391598

Cite this article as: Shortell, S.M., Gillies, R. & Wu, F. Public Health Rev 2010 32: 190. doi:10.1007-BF03391598


Population aging, rapidly increasing costs of healthcare and the growing burden of chronic disease are challenges to health systems worldwide. To meet these challenges will require new approaches to healthcare delivery and comprehensive population health management. Within the context of healthcare reform initiatives, important innovations in delivery system organization in the United States are discussed. The innovations focused on are the Patient-Centered Medical Home PCMH, the Accountable Care Organization ACO and the Population Health Management System PHMS combined with new payment arrangements that reward for health outcomes achieved rather than paying a fee for each service rendered. For each of these innovations, the evidence on its performance, the challenges involved, and the factors that might promote greater adoption and diffusion of successful models are reviewed. Finally, the role played by a country’s political system and its associated culture, structural barriers, size and resources, incentive alignment, and leadership are discussed.

KeywordsUnited States health reform Patient-Centered Medical Home Accountable Care Organization Population Health Management System  Download to read the full article text

Author: Stephen M. Shortell - Robin Gillies - Frances Wu

Source: https://link.springer.com/

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