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Coordination Of Care

PERSPECTIVE

Public Administration Barriers To Expanding Integrated Models

As I read the paper by Robert Master and Catherine Eng, I was reminded of an experience during my tenure as director of Colorado’s health care financing agency. I was meeting with the chief financial officer and a number of other senior executives from a then well-known, high-flying for-profit hospital chain.

"How much do you spend each year on the Colorado Medicaid program?" he asked.

"$1.3 billion," I replied.

His response: "We can do it for 1.2."

I laughed, but he was serious.

Experiences such as these, while perhaps amusing, also illustrate why public managers are hesitant to open the . . . [Full Text of this Article]

Flexibility versus program size.True risk adjustment.Quality and choice.Allocating costs.Expanded benefits.Systems of accountability.Care integration and cost-effectiveness.

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