In this issue of the journal, you will find a reflection of our ongoing emphasis on a key pillar of the new "ambulatory care management scene": the needed ingredients for a successful medical home. There are 3 key ingredients to a successful medical home (or any managed or coordinated care intervention for that matter): information, collaboration, and financial incentives. Ward highlights the importance of collaboration. Continuity as discussed by Nelson is a reflection of both collaboration and, in the case of the VA, the study site for this article, financial incentives. Battaglia highlights patient navigation, another aspect of collaboration. Cohen highlights how primary care physicians engage in self-management, one part of patient navigation. In future articles, we hope to publish original research on new collaborative techniques that primary care practices can engage in. In separate articles, Basu and Moczygemba highlight the net result of failures in any leg of the 3-legged stool-avoidable hospitalizations and emergency department visits. For sure, the most vulnerable are at greatest risk for avoidable encounters such as hospitalizations. From a macro perspective, Gold attempts to answer the question of how much demand there will be for these services as Medicaid programs continue to expand. Holt continues to explain to us how these phenomena continue to impact the Republic of Texas.

-Norbert I. Goldfield, MD

Editor