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The article in this issue "Community Care of North Carolina: Improving Care Through Community Health Networks" describes a decade-long program of quality improvement and cost reduction created by North Carolina Medicaid. The article provides lessons of value to all health professionals and leaders concerned with the cost and quality of care. (1)
LESSON 1: SIZE MATTERS
During the past 10 years, improvement work has flourished in a number of developed nations, including the United States. Most of this work, however, takes place in one institution--a hospital safety project or a primary care diabetes program-and is small. The Community Care of North ...