Author Affiliations: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care (Dr Wharam); and Department of Population and International Health, Harvard School of Public Health (Dr Daniels), Boston, Massachusetts.
In the United States, deficiencies in health care quality, value, and access are well documented.1- 5 Recent trends such as pay-for-performance, increased patient cost-sharing, and state health insurance expansion programs may represent important reforms and even a “tipping point” for the US health care system.6,7 Nevertheless, experts have cautioned that not only could unintended consequences occur but that no systems are in place to ensure accountability among policy makers.6,8,9
Wharam JF, Daniels N. Toward Evidence-Based Policy Making and Standardized Assessment of Health Policy Reform. JAMA. 2007;298(6):676-679. doi:10.1001/jama.298.6.676