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June 21, 2016

Toward an Integrated Federal Health System

Author Affiliations
  • 1Department of Medicine, Massachusetts General Hospital, Boston
  • 2New York City Health + Hospitals, New York, New York
  • 3Department of Population Health, New York University Langone Medical Center, New York, New York
JAMA. 2016;315(23):2521-2522. doi:10.1001/jama.2016.4641

The federal government is responsible for approximately 40% of health spending in the United States—about $1.3 trillion annually.1 More than 100 million individuals receive health coverage through the federal government or federal-state partnerships, and 4 federal agencies (Department of Health and Human Services, Department of Defense, Veterans Administration, Department of Homeland Security) provide direct health care services through hundreds of hospitals and thousands of clinics across the country. The 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.

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