Learning to Fly: Building De Novo Medical Home Practices to Improve Experience, Outcomes, and AffordabilityFernandopulle, Rushika MD, MPPJournal of Ambulatory Care Management: April/June 2013 - Volume 36 - Issue 2 - p 121–125 doi: 10.1097/JAC.0b013e3182871fac Original Articles Buy Abstract Author InformationAuthors Article MetricsMetrics While most approaches to improving primary care delivery involve making incremental improvements to existing practices, for the past decade we have been engaged in a different approach—to build new practices from the ground up to demonstrate a vision of what is possible. Our Iora model of care combines a new payment model which does away with all fee for service billing, a new delivery model focused on robust team-based population management, and a new IT system to drive this very different care. We have demonstrated in several pilots improved experience, outcomes, and lower total cost of care. Iora Health, Cambridge, Massachusetts; and Department of Medicine, Harvard Medical School, Boston, Massachusetts. Correspondence: Rushika Fernandopulle, MD, MPP, Iora Health, The American Twine Building, 222, 3rd St, Ste 3100, Cambridge MA 02142 (email@example.com). Rushika Fernandopulle is cofounder and chief executive officer of Iora Health. The author reports no conflict of interest. © 2013 Lippincott Williams & Wilkins, Inc.