McAllen, Texas, became a buzzword for high health care spending after Atul Gawande's recent New Yorker article. Less attention was paid to Grand Junction, Colorado, which that same article held out as a model of high-quality, low-cost care. President Obama plans to visit Grand Junction and see for himself this weekend.

How did Grand Junction become one of the nation's highest performing health care communities? We had heard about Grand Junction months ago, and began wondering about that ourselves. So for the last few months some of the New America health team has been studying the data, and talking to participants. We just released the case study: "Grand Junction, Colorado: A Health Community that Works."

You can read a summary here or the full paper here. Today and tomorrow on the blog, we'll l share some of the highlights.

Some of what Grand Junction does right can be replicated -- i.e. having a state-of-the-art health information technology system that many providers can access from a variety of settings to get a full picture of a patient's condition, medications, test results, and health history. Some may be a bit harder, such as forward-looking leaders in health care that have a strong sense of purpose and community, and who figured out how to align incentives and business practices so that what's good for the key players in health care was also good for the community as a whole -- including the sick and the uninsured.

"One of the most impressive things about Grand Junction is its ability to channel self-interest to serve societal interest. This is a major goal of comprehensive health reform," said Len Nichols, director of the health policy program at New America.

The case study analyzes features of Grand Junction health care including::

• Quality over quantity. Incentive contracts between physicians and the area's largest insurer help move providers away from fee-for-service, pay-for-volume reimbursement. High quality care is rewarded -- particularly if it's high quality and efficient.
• A safety net that not only catches but embraces the needy. A clinic for the uninsured is located on the grounds of one of the major hospitals in the community. Eligible uninsured patients who show up in the ER get transferred over to the clinic for follow up or ongoing care, with care provided free or on a sliding scale. The clinic offers them a same-day, one-stop shopping for primary, preventive and behavioral health. If they need to see a specialist, the clinic can call on a network of volunteers. The coordinated safety net reduces the cost (and cost-shifting) of caring for the uninsured. Every patient receives quality care regardless of income or insurance status.
• Transparent performance data, peer-to-peer feedback, and information sharing that encourages doctors to collaborate and communicate. Physicians learn how much each test, drug, specialist referral, and hospitalization cost the health plan. This transparency, coupled with quality measurement, raises physicians' cost-consciousness, and, along with the incentive contracts, channel physicians' competitiveness into efficiency rather than revenue maximization.
• A strong primary care physician workforce that coordinates treatment. Team-based care is common, and the health IT enables disease management and care coordination among multiple physicians and facilities. Primary care doctors are encouraged (and compensated) for seeing their patients in a hospital, even if they are under the care of a specialist. That promotes good communication and smooths transitions and follow-up care from hospital back to the community.
• Innovative community service organizations that play a key supporting role in filling the community's health care needs from birth to death. Make that even before birth: prenatal care is excellent and available to benefit the next generation of Grand Junction residents.

Tomorrow, we'll look at some other aspects of what the community is doing right -- and what the rest of the country can learn about getting to high-quality, lower-cost health care faster than we might have imagined.