The delivery system matters

To meet the quality, affordability, and access challenges of today's health care system, the Institute of Medicine's (IOM's) Crossing the Quality Chasm report described the critical competencies of a twenty-first-century health care system. A growing body of research suggests that the nation's multispecialty group practices most nearly meet the delivery system challenges set forth by the IOM. A variety of current public and private initiatives and potential policy options could act as catalysts for the development and spread of group practice-based, accountable delivery systems that are effective and efficient.