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U.S. Health Care 'Substandard,'Says IOM Report

Managed care — a whipping boy for all that is wrong with health care in the U.S. — is not to blame for a badly fragmented system that provides incentives to treat acute episodes and not manage chronic illness, according to the Institute of Medicine's landmark report on the quality of care in America. Instead, the IOM says, the "substandard" level of care in the U.S. is an "across-the-board problem."

The IOM took the health care system to the woodshed for providing duplicate services, ignoring patient needs, and not promoting payment schemes that reward prevention and quality improvement.

Noting that it can take 17 years for clinical discoveries to become part of a physician's repertoire, the IOM called on the Agency for Healthcare Research and Quality to identify 15 key chronic conditions, and on providers and insurers to craft collaborative action plans to improve treatment of those costly conditions.

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