Cigna's Collaborative Accountable Care initiative provides financial incentives to physician groups and integrated delivery systems to improve the quality and efficiency of care for patients in commercial open-access benefit plans. Registered nurses who serve as care coordinators employed by participating practices are a central feature of the initiative. They use patient-specific reports and practice performance reports provided by Cigna to improve care coordination, identify and close care gaps, and address other opportunities for quality improvement. We report interim quality and cost results for three geographically and structurally diverse provider practices in Arizona, New Hampshire, and Texas. Although not statistically significant, these early results revealed favorable trends in total medical costs and quality of care, suggesting that a shared-savings accountable care model and collaborative support from the payer can enable practices to take meaningful steps toward full accountability for care quality and efficiency.

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"Patient Portals" enable patients to review their medical record and add information to it. Clinics are using "E-Visits" to substitute for a face-to-face office visit. This article describes the experience of one healthcare system with "Patient Portals" and "E-Visits."

A comprehensive Code of Ethics for the members of the American Association of Physicists in Medicine (AAPM) is presented as the report of Task Group 109 which consolidates previous AAPM ethics policies into a unifi ed document. The membership of the AAPM is increasingly diverse. Prior existing AAPM ethics polices were applicable specifi cally to medical physicists, and did not encompass other types of members such as health physicists, regulators, corporate affi liates, physicians, scientists, engineers, those in training, or other health care professionals. Prior AAPM ethics policies did not specifi cally address research, education, or business ethics. The Ethics Guidelines of this new Code of Ethics have four major sections: professional conduct, research ethics, education ethics, and business ethics. Some elements of each major section may be duplicated in other sections, so that readers interested in a particular aspect of the code do not need to read the entire document for all relevant information. The prior Complaint Procedure has also been incorporated into this Code of Ethics.

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