Learning to fly: building de novo medical home practices to improve experience, outcomes, and affordability

J Ambul Care Manage. Apr-Jun 2013;36(2):121-5. doi: 10.1097/JAC.0b013e3182871fac.


While most approaches to improving primary care delivery involve making incremental improvements to existing practices, for the past decade we have been engaged in a different approach-to build new practices from the ground up to demonstrate a vision of what is possible. Our Iora model of care combines a new payment model which does away with all fee for service billing, a new delivery model focused on robust team-based population management, and a new IT system to drive this very different care. We have demonstrated in several pilots improved experience, outcomes, and lower total cost of care.

MeSH terms

  • Diffusion of Innovation
  • General Practice / economics
  • General Practice / organization & administration*
  • Health Expenditures*
  • Humans
  • Models, Theoretical*
  • Patient Satisfaction*
  • Patient-Centered Care / economics
  • Patient-Centered Care / organization & administration*
  • Practice Management, Medical / economics
  • Practice Management, Medical / organization & administration*
  • Primary Health Care*
  • Treatment Outcome*
  • United States