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Sharing care to achieve the triple aim of health care delivery.

patients cared for by oncologists alone are less likely to be managing these comorbid conditions or receiving indicated preventive care. In contrast, when patients are seeing both primary and oncologic care providers, they are more likely to be managing the comorbid conditions and receiving indicated preventive care. To achieve the second aim of improving the care of patients, we need to manage the whole constellation of medical problems people face; we need to think about sharing care among providers and taking care of people, not diseases. Sharing care makes sense both medicallyand financially. The Ben-Ami et al study asked whether people on chemotherapy wanted their primary care physician to be involved in their oncologic care. The three most common comorbid conditions among individuals ages 65 are high blood pressure (58%), high cholesterol (45%), and ischemic heart disease (31%). 8 These are not oncologic problems, and they are managed well by primary care. Even if oncologists managed them well, the costs are much higher than in primary care because salaries are substantially higher. 10 Having people seek care for nononcologic conditions in primary care makes good medical sense and will help reduce per capita costs for care. However, the Ben-Ami article has limitations. We do not know the applicability of findings from Israel to realities here in the United States. The Israeli system is based on primary care, and 96% of the patients undergoing chemotherapy stated they