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Pew revisited: recommendations for the 21st century

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Time for tiering?

In the state of Washington, health plans have tiered networks for primary care physicians. This particular tiering is based on clinical outcomes, most notably clinical efficacy and patient satisfaction. As the health care system emerges and matures, we suspect that all doctors will be profiled and monitored not only for cost but also for clinical outcomes and patient satisfaction. Web sites such as www.healthgrades.com are an example of this trend.

Tiering of the chiropractic profession has been

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