"With lots and lots of specialists, it becomes more and more difficult for that primary care physician to really keep track on what is going on," she says. "We see simple stuff fall through the cracks, the more chaotic the care is."
So, there's the need for coordination of care, she says, more than ever. In some variations, we've heard that before, in the calls for Accountable Care Organizations. Fisher, known as one of the innovators of ACOS, wrote in Health Affairs in 2009 his proposal to "achieve more integrated and efficient care by fostering local organizational accountability for quality and costs through performance measurement and "shared savings" payment reform."
With this study, Fisher, Brownlee and their colleagues again are calling 911: coordinated care is needed now.