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Viewpoint |

Toward an Integrated Federal Health System

Dhruv Khullar, MD, MPP1; Dave A. Chokshi, MD, MSc2,3
[+] 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.
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This Viewpoint discusses the fragmented nature of the current US federal health system and proposes approaches for achieving a more integrated and efficient system.

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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