International learning on increasing the value and effectiveness of primary care (I LIVE PC) New Zealand

New zealand (nz) has a central government-driven,tax-funded health system with the state as dominant payer. the nz experience precedes and endorses the us concept of patient-centered medical homes providing population-based,nonepisodic care supported by network organizations. these networks provide administration,budget holding,incentivized programs,data feedback,peer review,education,human relations,and health information technology support and resources. key elements include enrolled populations; an interdisciplinary team approach; health information technology interoperability and access between all providers as well as patients; devolution of hospital-based services into the community; intersectorial integration; blended payments (a combination of universal capitated funding,patient copayments,and targeted fee-for-service for specific items); and a balance of clinical,corporate,and community governance. in this article,we discuss reforms to nz's primary care arrangements over the past 2 decades and reflect on the lessons learned,their relevance to the united states,and issues that remain to be resolved.