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As Congressional lawmakers continue efforts to craft health reform legislation that will help improve patient care and curb rising costs, several communities have independently undertaken efforts to achieve such goals, the Associated Press reports. These locations, which President Barack Obama has called "islands of excellence," include a program at Danville, Pa.-based Geisinger Health System that charged patients insured through the system's insurance unit having elective coronary artery bypass graft surgery a flat fee with a 90-day "warranty." Geisinger relied on national guidelines to establish standardized care protocols for patients in its ProvenCare initiative, which has resulted in faster recoveries, a steep drop in rehospitalizations and thousands of dollars in savings since it was launched in 2006. Based on the success of the program, Geisinger has expanded ProvenCare to other elective surgeries and treatments, including joint replacement and bariatric surgery, and is negotiating with other insurers for inclusion in the program. Meanwhile, two competing hospitals in Cedar Rapids, Iowa, have partnered to establish a community clinic that reduced side effects and hospitalizations of patients using blood thinners. The hospitals are planning to expand their partnership to reduce unnecessary CT scans, because approximately 52,000 scans were ordered, but only about 1 percent actually detected a problem. In a third example, the AP examines an Everett, Wash., initiative that ensures patients receive a checkup call after they are discharged from a hospital (Neergaard, AP/Washington Post, 9/8/09 [registration required]).