Chapter 19: Leading by Example: Why Oregon Matters in the National Health Reform Discussion

America's health care system is experiencing a period of transformative change. Following the passage of the Affordable Care Act in 2010, state and federal policymakers embarked on an unprecedented effort to develop new payment and delivery models that aim to realign incentives and emphasize accountability for quality and efficiency. Providers and other stakeholders have, in turn, signaled a willingness to make substantial investments-deploying both human and financial resources-to develop the capabilities to succeed in a value-driven world. But with the creation of such a diverse set of approaches, it is important to understand and learn from the experiences of others as we refine efforts moving forward. One model in particular-an ambitious plan for reform focused on leadership and accountability at the local level-is garnering attention as experts focus on the next phase of transformation. That initiative, developed and implemented under the leadership of Governor Kitzhaber in Oregon, offers valuable lessons as we contemplate the future of health care in our country.