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Family Medicine: Preparing for a High-Performance Health Care System

The Issue

Health policy experts agree that a strong primary care system is central to a high-performance health system. In a special supplement to the Journal of the American Board of Family Medicine, The Commonwealth Fund's Karen Davis, Ph.D., and Kristof Stremikis, M.P.P., make the case for reforming U.S. health care financing and delivery to improve the accessibility of primary care and ensure accountability for that care throughout the health system.

What the Study Found

The authors first compare patient-centered primary care in the U.S. with other countries, finding the U.S. lagging in many areas, including access, use of clinical information systems, and care coordination. They then highlight various models of patient-centered medical homes that have been implemented throughout the country, such as the TransforMED project, which engages family medicine providers in redesigning their practices to provide patient-centered care; the Geisinger Health System's "personal health navigator," which employs care teams, case management, and other components to reduce costs and hospital admissions for high-risk Medicare patients; and initiatives undertaken by private insurers that reward physicians for improving quality.


The Commonwealth Fund is supporting evaluations of many of these medical home models, which already are yielding important lessons for health professionals, say the authors. In moving forward, "family physicians will continue to be called on to lead change and advance patient-centered care models," they conclude.

Publication Details



K. Davis and K. Stremikis, "Family Medicine: Preparing for a High-Performance Health Care System," Journal of the American Board of Family Medicine, March–April 2010 23(Suppl. 1):S11–S16.