1. Many needs, many models. This scenario is a natural extensionof health care as many Americans know it. The scenario forecasts ashortage of primary care physicians, increased emphasis on diseaseprevention, growth in electronic medical recordkeeping, a shiftfrom employee-based insurance to health insurance exchanges, andgrowing disparities in access to and quality of primary care basedon income and where people live.
  2. Lost decade, lost health. This scenario forecasts a shortage ofprimary care physicians, declining income for practicing physiciansand more uninsured patients, some of whom resort to black marketcare and unreliable online advice. Patients with good insurancehave access to great care enhanced by advanced technology
  3. Primary care that works for all. This scenario assumes nearlyuniversal health care coverage, with 85 percent of patients usingintegrated systems staffed by collaborative teams of health careproviders, including physician assistants, nurse practitioners andhealth coaches who work closely with patients. Seeking to providebetter care at lower cost while improving the health of thepopulation they serve, primary care teams join with communitypartners to address factors that affect a community's health,including employment, educational attainment, housing,transportation, and access to fruits and vegetables.
  4. Consumer is boss. Under this scenario, four of 10 patients optfor consumer-directed health plans, which include catastrophicinsurance with high deductibles. For the most part, savvy consumersuse advanced technologies, including noninvasive biomonitors, aswell as wellness and disease management apps, to stay healthy.Large vendors offer free avatar-based health coaching to consumerswho purchase other integrated health products and services.Consumers shop for the best doctor and buy on the basis of highquality and low price.
 

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