January 1992
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161 Reads
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7,388 Citations
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January 1992
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161 Reads
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7,388 Citations
... Our causal-loop analysis indicates that the coordinated care model consists of two nested goal-directed balancing feedback loops in which CCO performance is dependent on clinic performance, and both CCOs and clinics operate under standards set by the state. In the systems science literature, goal-directed feedback loops are considered an engine of change in the sense that the tension created from the gap between current and desired performance leads to corrective action [37]. By incentivizing the CCOs to support clinic QI efforts, the coordinated care model is structured to improve clinic QI capacity. Figure 2C shows that the primary types of support provided to clinics by CCOs act on each part of the clinic performance balancing loop. ...
January 1992