The region of West Central Michigan encompassing Grand Rapids and surrounding communities ranks in the top quartile among 306 U.S. regions evaluated by The Commonwealth Fund's Scorecard on Local Health System Performance, 2012, performing especially well on measures of prevention and treatment quality, avoidable hospital use, and costs of care. This relatively higher performance may stem from the area's conservative medical practice style and local stakeholders' stewardship of community health and health care, as illustrated by a long history of regional planning and accountability for promoting the efficient use of resources. Complementary efforts and incentives to improve quality of care, community outreach programs, and a commitment to strengthening the safety net also may influence regional performance. However, more recently, rising costs and increasingly competitive market dynamics appear to be challenging the social contract that has long guided community cooperation.
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