One health system CEO described the situation as follows ( NEJM / Catalyst ):
“ The concept that our fee-for-service system is fundamentally flawed is not new or innovative . We know we need to change . What paralyzes us is fear that we cannot effectively and nimbly turn around the $ 3.5 trillion aircraft carrier that is American health care . The federal government and both political parties know that we must transform our system to pay for health rather than sickness . For over a decade we have been pussyfooting around , taking baby steps toward what we have deemed value-based care . 4 We have made trivial progress .”
— R . Lawrence Moss , MD , FACS , FAAP , President and Chief Executive Officer , Nemours Children ’ s Health System
While focused on these and many other initiatives , our world was changing dramatically . Generation Y replaced Baby Boomers as the dominant group fueling the healthcare workplace . The number
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