This JAMA piece by Dhruv Khullar, M.D., and Dave A. Chokshi,  M.D., look at the  need for the federal government to integrate its health programs.

They note that “{t}he breadth, complexity, and incremental development of the federal health system have resulted in a fragmented patchwork, with many potential areas for integration to increase efficiency and improve care coordination.”

They suggest (in considerable detail) five ways could be improved:

• “Minimizing overlapping service delivery and procurement.”

• “Reducing duplicate payments.”

• “Repurposing underutilized facilities.”

• “Integrating information technology systems.”

• “Expanding value-based purchasing.”