The current trajectory of health care spending in the United States, as a percent of the GDP, is not sustainable. Over the last decade there has been a movement toward value-based purchasing in health care. Two landmark reports published by the Institute of Medicine (IOM) set the direction for quality improvement in the health care field. To Err Is Human, published in 1999, highlighted that as many as 98,000 patients die each year because of preventable medical error. In March 2001, with its report Crossing the Quality Chasm: A New Health System for the 21st Century, the IOM called for a fundamental change to close the quality gap in health care. This set the direction toward a focus on quality and value by policymakers, regulators, payers and purchasers of health care. Value, as defined by Michael Porter,...

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