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July 2, 2008

Physician Roles, Payment Models, and Partnerships in Primary Care

JAMA. 2008;300(1):44. doi:10.1001/jama.300.1.44-a

To the Editor: Although we were flattered and pleased to see our pilot project cited in the Commentary on physician roles and payment models in primary care by Drs Baron and Cassel,1 we wanted to clarify the structure and governance of the ambulatory intensive care unit described as “being tested with the Hotel Employees and Restaurant Employees International Union in Las Vegas and Atlantic City.” The sponsor is actually a Taft-Hartley Benefit Trust, which is a partnership of the union and the employers and is governed by trustees from both groups. The pilot, which is currently operating only in Atlantic City, is a 50-50 partnership with AtlantiCare, a regional integrated delivery system. These additional details make clear that our “innovative effort” is composed of partnerships in addition to the union, and we hope other creative partnerships will emerge to pursue the important goals articulated in the article to strengthen primary care for the sickest individuals in the service of improved and more affordable health care for employees and employers alike.