Models of Physician Practice is a scholarly collection on an important part of the health care delivery system, physician group practices. This book shows that through new, cutting-edge research--pre-paid group practices are a cost-efficient, high quality alternative to the commercial HMO.

Tables and Exhibits ix Acknowledgments xi The Contributors xiii Foreword xxiiiWilliam L. Roper Preface xxviiAlain C. Enthoven, Laura A. Tollen 1 Prepaid Groups and Organized Delivery Systems: Promise, Performance, and Potential 1Stephen M. Shortell and Julie Schmittdiel 2 Systems and Results: The Basis for Quality Care in Prepaid Group Practice 22Donald M. Berwick and Sachin H. Jain 3 The Clinical and Economic Performance of Prepaid Group Practice 45Kenneth H. Chuang, Harold S. Luft, and R. Adams Dudley 4 Prepaid Group Practice and Health Care Policy 61Jon B. Christianson and George Avery 5 Technology Assessment, Deployment, and Implementation in Prepaid Group Practice 85David M. Eddy 6 Managing the Pharmacy Benefit in Prepaid Group Practice 108William H. Campbell, Richard E. Johnson, and Sharon L. Levine 7 Prepaid Group Practice and Medical Workforce Policy 128Jonathan P. Weiner 8 Prepaid Group Practice and Health Care Research 156Raymond Fink and Merwyn R. Greenlick 9 Physician Leadership: “Group Responsibility” as Key to Accountability in Medicine 179Francis J. Crosson, Allan J. Weiland, and Robert A. Berenson 10 The Limits of Prepaid Group Practice 199James C. Robinson 11 The Relationship Between Prepaid Group Practice and the Employer Community 213Helen Darling 12 Open the Markets and Level the Playing Field 227Alain C. Enthoven Editors’ Introduction to the Epilogue 247 Epilogue: Prepaid Group Practice and Computerized Caregiver Support Tools 249George C. Halvorson Appendix: The Origins of Prepaid Group Practice in the United States 265Jon A. Stewart Index 275

Toward a 21st Century Health System Toward a 21st Century Health System's contributors include George Avery, M.P.H., University of Minnesota School of Public Health and University of Minnesota-Duluth Department of Psychology Robert A. Berenson, M.D., F.A.C.P., The Urban Institute Donald M. Berwick, M.D., M.P.P., Institute for Healthcare Improvement William H. Campbell, Ph.D., University of North Carolina at Chapel Hill, School of Pharmacy Jon B. Christianson, Ph.D., University of Minnesota, Carlson School of Management Kenneth H. Chuang, M.D., San Francisco Veterans Affairs Medical Center Francis J. Crosson, M.D., The Permanente Federation Helen Darling, M.A., National Business Group on Health R. Adams Dudley, M.D., M.B.A., U.C. San Francisco, Institute for Health Policy Studies David M. Eddy, M.D., Ph.D. Alain C. Enthoven, Ph.D., Stanford University, Graduate School of Business. Raymond Fink, Ph.D., Medical and Health Research Association of New York City Merwyn (Mitch) R. Greenlick, Ph.D., Oregon Health and Science University Medical School George C. Halvorson, Kaiser Foundation Health Plan and Hospitals Richard E. Johnson, Ph.D., R.Ph., Center for Health Research, Kaiser Permanente Northwest Sharon L. Levine, M.D., The Permanente Medical Group Harold S. Luft, U.C. San Francisco, Institute for Health Policy Studies Sachin H. Jain, Institute for Healthcare Improvement James C. Robinson, Ph.D., U.C. Berkeley, School of Public Health Julie Schmittdiel, M.A., U.C. Berkeley, School of Public Health Stephen M. Shortell, Ph.D., U.C. Berkeley, School of Public Health Jon A. Stewart, The Permanente Federation Laura A. Tollen, M.P.H., Kaiser Permanente Institute for Health Policy Allan J. Weiland, M.D., Northwest Permanente, P.C. Jonathan P. Weiner, Dr.P.H., Johns Hopkins University, Bloomberg School of Public Health Praise for Toward a 21st Century Health System After three decades of trying to reform health care by looking for a "silver bullet," I found the "future" has been here for more than a century. Policymakers tired of banging heads and gavels on stone walls need look no further than this well-designed analysis of prepaid group practice for the incentives necessary to enhance health system quality, safety, and performance, expand access and equity, and vastly improve the professional-patient relationship. —Hon. David Durenberger, U.S. Senator (1978-1995), Senior Health Policy Fellow, University of St. Thomas If you wonder why the American health system is judged by distinguished experts as "the poster boy of underachievement," read this collection of fine essays by longtime students of that system. The book is a particularly valuable read for students of medicine, health administration, and health policy. Here they will learn how much better value might be wrung out of the health system for the truly ample resources Americans grant it. —Uwe Reinhardt, James Madison professor of Political Economy, Princeton University