As a local State program, Tenncare under the leadership of The Medical Director Dr. Vaughn Frigon, with the assistance of the McKinsey consulting team, has demonstrated exemplary success and is a model for other Medicaid programs. The secret of their success has been careful physician engagement in episode details, due to given the design of the State of Tennessee's program, and transparency of information. Given the success of the episodes program, the question arises of what can be done next?

An important game changing article that puts Value in a new light is in the NEJM Dec 21, 2017 issue by Green and Loscalzo. The title is "Putting the Patient Back Together - Social Medicine, Network Medicine, and the Limits of Reductionism". Many widely known and emergent tools are explained that can bear on the current understanding of Value in the healthcare context. Most importantly this article shows how holistic patient centered approaches are not only cool, but doable and can be effective in achieving a broad range of goals on behalf of patients and populations.

The PCMH Congress met for the third time in Orlando (Nov 3-5 2017); the program is catching on, there are now about 1000 accountable organizations of record, including ACA's and PCMH's.

I will be presenting the “Pyramid of Value” in the Poster Hall of the 2017 PCMH Congress, November 3rd & 4th, Regency Ballroom, Hyatt Orlando Florida. For more information please visit the PCMH Congress 2017 page and/or the PCMH Congress website.