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Alain C. Enthoven, Francis J. Crosson, and Stephen M. Shortell ‘Redefining Health Care’: Medical Homes Or Archipelagos To Navigate? Health Affairs, September/October 2007; 26(5): 1366-1372. [Abstract] [Full Text] [PDF] [Reprints & Permissions]

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Medical Homes Versus Archipelagos

Mitchell T. Rabkin, John S. Cook   ( 11 September 2007 )

Medical Homes Versus Archipelagos 11 September 2007
Mitchell T. Rabkin, Professor of Medicine; CEO Emeritus Harvard Medical School; Beth Israel Deaconess Medical Center, John S. Cook Send comment to journal: Re: Medical Homes Versus Archipelagos mrabkin{at}bidmc.harvard.edu Mitchell T. Rabkin, et al.	Enthoven et al. are correct in their critique of Porter and Teisberg's notion of integrated practice units (IPUs). That 75 percent of Medicare beneficiaries are under treatment for three or more conditions underscores the impracticality of the IPU. Enthoven's emphasis, "Recognition of the essential coordinating role of primary care, as part of an overall organized system of care, along with alignment of providers' incentives with patients' desires for high-quality, affordable, and accessible care, could lay the foundation for truly redefining U.S. health care," recalls our 2002 article, cited below, which offers basic ideas for just such an approach. Others have since been voicing similar thoughts, further emphasizing the direction that warrants serious exploration in the effort for health care reform. J.S. Cook and M.T. Rabkin, "A New Approach to Medicare: Implications for Health Care Reform and for Medical Education," Academic Medicine 77, no. 11 (2002): 1069-1075.