McAllen, Texas, got a lot of attention recently after the New Yorker's Atul Gawande turned our attention to its profligate health spending ways. (New town slogan could be "McAllen: Unnecessary Procedures Capital of the World." )

Less conspicuous but perhaps more important was Gawande's mention of Grand Junction, Colorado, a community that spends relatively little on health care while delivering high quality outcomes. One of its secrets: Where McAllen had a culture of profit, Grand Junction has a culture of collaboration.

"Years ago the doctors agreed among themselves to a system that paid them similar fees whether they saw Medicare, Medicaid or private-insurance patients, so that there would be little incentive to cherry-pick patients," Gawande wrote. "They also agreed, at the behest of the main health plan in town, an HMO, to meet regularly on small peer-review committees to go over their patient charts together. They focused on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates."

I personally first heard about Grand Junction about a year ago—maybe it was at our farewell lunch for a summer intern, Elena Harman, an extremely bright MIT student (is there any other kind?) who was from Colorado and knew about Grand Junction. Now, the local newspaper, the Grand Junction Free Press, spoke to two experts in Grand Junction who had some thoughts on what the rest of the country might be able to replicate.

The main health plan in town is Rocky Mountain Health Plans, an HMO. It has worked with local doctors to create a regional information network so various doctors can see their patients' complete  medical records and test results. A few years ago the health plan and the Independent Physicians Association each put in $500,000 as seed money to form a physicians network called Quality Health Network.

Michael J. Pramenko, a family physician at Primary Care Partners, says Rocky Mountain Health Plans has an unusual relationship not just with the neighborhood docs but with Medicare. "This is the only place in the state where Medicare works with an insurance company to provide better access," he said.

Steve ErkenBrack, president of Rocky Mountain Health Plans, said he's been trying to share the good news throughout Colorado.

"Time and again I've said this is how we do things in western Colorado," he said. "It's been clear to us that this is a very good model." It takes more than a plan written on a piece of paper, he cautioned. It takes commitment, and buy-in from insurance providers, medical providers and every one else involved in delivering and paying for health care. The upshot then is that everyone is "invested in each other's success."