Chapter 1

Group Practices Provide Better—and Cheaper—Care

Winter in Cleveland can be beautiful when the air is crisp and the evergreens are cloaked in white. But by mid-March, with its bare trees and gray skies, a longing for something more alive fills the air. Against this backdrop, Lisa Cant-well, a woman in her twenties, saw her doctor for a prenatal ultrasound. Already the mother of two young children, she had been through prenatal testing before. But nothing could have prepared her for the ordeal that she and her husband, Josh, were about to face.

The ultrasound, performed at 18 weeks, showed something in the baby’s neck—a dark mass, six centimeters across. In 35 years, Lisa’s prenatal specialist had never seen anything like it.

Several ...

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