Transforming Health Care to Address Value and Equity: National Vital Signs to Guide Vital Reforms

The US health care system is failing to deliver value and equity. Life expectancy has been declining nationally.' Health care costs in the United States are the highest in the world. Medicare alternative payment models have yielded modest reductions in costs but have generally not improved health or equity. Fundamental change is needed beyond redesign of alternative payment models. Health care must embrace equitable improvement in the national Vital Signs initiative, invest in primary care, and collaborate with communities.