The United States faces a fiscal crisis due to unsustainable growth in federal spending at rates significantly higher than inflation. Entitlement spending represented nearly 62% of the federal budget in 2012.1 Medicare accounts for the majority of federal health care spending with the fastest rate of growth because of increased enrollment and utilization of services, increased severity of illness and treatment intensity, and faster growth in prices.2 At the same time, the quality of US health care has been called into question following a series of landmark reports by the Institute of Medicine (IOM). These observations underlie current health care reform efforts.
Gourin CG, Couch ME. Defining Quality in the Era of Health Care Reform. JAMA Otolaryngol Head Neck Surg. 2014;140(11):997-998. doi:10.1001/jamaoto.2014.2086