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—Dr Smith appropriately has raised the concern that costs of medical care are greater in academic health centers than in community-based practice. We are not proposing that additional grants be made directly to academic centers to provide medical care on site. Our recommendation is to provide financial incentives to academic health centers, dependent on their being involved in a true partnership with their communities, using complements to traditional medical care located in neighborhoods to address health care needs in a more timely, effective, and less costly manner. To enhance the economic well-being as well as the health status of community populations, our approach places the emphasis on community development and leadership and on community-based health promotion and disease prevention programs operated by neighborhood-based, culturally sensitive personnel. Such an approach thus would provide less costly community-based programs that are designed to decrease the need for more expensive hospital-based care
Levine DM, Becker DM, Bone LR, Hill MN, Tuggle MB, Zeger SL. Community-Academic Health Care Partnership-Reply. JAMA. 1995;273(6):460. doi:10.1001/jama.1995.03520300030030