medical economics

There is a structure to how we have organized care. Primary care physicians care for our day-to-day and chronic illnesses while helping us navigate the landscape to find specialists and hospital care when that is needed. They are our Sherpas – knowledgeable of the landscape and its pitfalls and nuances. You wouldn’t attempt to climb Everest without them. Ultimately, because a rope connects you, you must trust them with your life. While that may be a bit dramatic an analogy for a primary care physician, that rope, that trust, is built from many smaller, lower risk encounters. A consistent health Sherpa results in better care.
Because Medicare Advantage programs are paid in part, by the value their care-partners provide, they choose their partners carefully. And when incentives are aligned, patient outcomes seem to improve. 
A recent study led to an obvious question: Why have greater utilization of a hospital's Intensive Care Unit and invasive procedures if it doesn't improve mortality?