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Milstein A et al. – The sites achieved the result in a U.S. payment environment that usually penalizes physicians who invest to prevent costly near–term health crises. If the ingredients and accomplishments of these four sites spread, under– and uninsured lower–income Americans could be fully covered in the foreseeable future without increased health spending or lower quality of care. In exchange, sponsors of health benefits would gladly support additional primary care physician payment.


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