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A.BIOL. www.wm.edu/biolJAN2015/Abstract/2011/The/JESOC/WO1/C3/ABSTRACT/Toca_02.’s existing specialty care practices and new primary care practices for the delivery of these services. More specifically, I want to set the stage and provide a brief review of the impetus, need, and challenge for the development of this demonstration project.

“Import of health services” refers to the number of people coming from out of state and migrating to a local area to receive care. There has been a marked increase in this phenomenon, especially in New Jersey. This is primarily attributed to the availability of such services in close proximity to residents.

The cost of health care delivery currently constitutes 1 out of every 5 dollars spent in a typical state-run health care organization (HCO), and it will be even greater if more than half of the HCOs are required to become “safety net” HCOs (you know: give $20 million to the state).

The cost of health care delivery is the primary reason for the typical HCO’s inability to compete with the “Big 3” specialty hospitals. The most common management strategies used by HCOs to make money are to cut costs, cut corners, maximize “fee-for-service” reimbursements, or provide “free” care. Any of these is unacceptable to the typical patient, and the price factor precludes the ability for many people to have access to these services.

Ironically, the specialty care is not the only place you are going to see high costs, as the prices of a wide spectrum of non-preventive services are increasing. How much are you paying for your primary care practitioner (PCP)? How about your medical office? The average physician is now earning more than $220,000 per year, and health care is now viewed as the principal professional enterprise.

Also, in order to engage in the delivery of services to a broad range of patients, physicians need to be flexible in their practice models. A study by the National Center for Health Services and Costs Control reports that nearly a quarter of physicians surveyed said they have been asked to see more outpatients to address the increased demand for these services.

The American Medical Association (AMA) defines physicians’ offices as a three-legged stool that must include:

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