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This has already begun to take effect with the Affordable Care Act as the logic of "fee for outcomes" has begun to replace the "fee for visit" system.
These approaches have included: the classic general extension service; commodity based services; the training and visit system; participatory services linked with producer associations; project driven services; the farming systems approach; and the educational/institutional (University based) extension approach.
Explanatory fixed factors included whether an explicit diagnostic code was present in VCR, whether it was a first or a follow up visit, system diagnosis in CCR (categorized as joints, skin and hooves, respiration, skeletal and other), gender and usage category.
What ever change future will bring to the home visit system as it now stands: the quality of primary health care must be maintained while an out-dated system will have to be modernised so that it can deal with the shifting population demographics.
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America's US-VISIT system is fraught with flaws and cost overruns.
"There have been no attacks on the US-VISIT system," Mocny said.
"We have proven out the return on investment," said Eric Sting, project leader on Accenture's bid for the U.S.-Visit system.
U.S. officials have called the US-VISIT system a cornerstone of the nation's efforts to stop terrorists at the borders and stanch the flow of illegal immigrants.
The United States Visitor and Immigrant Status Indicator Technology (US-VISIT) system under development is intended to track all foreign visitors entering and leaving the United States.
Moreover, critics said the Department of Homeland Security had given the three contractors who are bidding on the project -- Accenture, Lockheed Martin and the Computer Sciences Corporation -- wide latitude in specifying the technology and capabilities of the U.S.-Visit system.
But many experts feel it is no coincidence that a steep drop in infant deaths followed the start of an intensive home-visiting system run by the Cary Christian Center, using local mothers as counselors.
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