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Konstam MA et al. – Although rewards and penalties based on specific externally driven metrics may be useful as an intermediate step in the current fee–for–service environment, this approach has important limitations and should transition quickly to a medical home approach. The current drive to change US health care should seek to transform the system of reimbursement and care to one that provides for continuous multidisciplinary management of all patients, including those with complex, chronic conditions such as heart failure.


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