Lawrence Casalino: lessons from the US on commissioning

The proposed reforms to the English NHS set out in the recent white paper, aim to decentralise power in the NHS by giving more financial autonomy to primary care physicians and hospitals.

The central proposal to create consortia of primary care physicians bears some similarities to Independent Practice Associations (IPAs) in the US – networks of small practices that come together to contract with health plans. The experience of IPAs, those that failed and those that survived and succeeded into the long term, have important lessons for developments in England.

Dr Lawrence Casalino, Livingston Farrand Associate Professor of Public Health and Chief of the Division of Outcomes and Effectiveness Research at Weill Cornell Medical College, reflects on what the NHS might have to learn from the US about GP commissioning.