ABSTRACT

The historic healthcare reform bill makes clear that the focus of the twenty-first century healthcare system is cost control. A major mechanism to achieve cost control is integrated care: improved cost effectiveness by better prevention and management of chronic disease, improved delivery of these services in primary care, increased use of evidence-based practices, and new payment mechanisms such as pay-for-performance incentives to encourage best practices (see Chapter 12, this volume). Providers are urged to be more accountable for healthcare costs and results and to demonstrate cost effectiveness (Antos et al., 2009). In addition, cost control will be achieved by reduced reimbursement rates for Medicare and Medicaid programs. The writing is on the wall: Integrated care, accountability, and cost savings are the focus of healthcare reform.