This issue continues the theme issue on the Medicare Health Outcomes Survey (HOS) edited by Professor Lewis E. Kazis.

Delivery system reform, if it is to be successful (defined as improved outcomes in combination with stabilized or even decreasing costs), needs to provide a combination of financial incentives and collaborative care. Collaborative care is needed within the health care team (health professionals and the patient) dealing directly with the patient and between institutions/health care delivery systems that purport to provide coordinated care.

We continue with a report about health care developments in the Republic of Texas.

-Norbert I. Goldfield, MD

Editor