Seeds of Reform: A Timeline

How does a nation work towards supplying more citizens with higher-quality health coverage on a smaller tab?  By moving away from a delivery model that rewards volume (e.g., more care “transactions”), and towards one that rewards value.

While the recent Affordable Care Act has lit a fire beneath us as a nation, the seeds of change actually have been sown for some time now. Below, we walk you though some of the biggest milestones paving the way for reform.

seeds of reform


Health policy pioneers, including Lucian Leape, M.D. and Don Berwick, M.D., publish the Institute of Medicine’s landmark report “To Err Is Human: Building a Safer Health System.” The report reveals a staggering statistic: Up to 98,000 people die annually due to medical errors.


A consortium of large employers – The Leapfrog Group – is born, as business leaders begin discussing how they can work together to influence health care quality and affordability (previously, employers spent billions of dollars on their employees’ health care with no good means of assessing its quality or comparing providers).


The Institute of Medicine publishes its next landmark report, “Crossing the Quality Chasm,” outlining how care can better be coordinated to achieve better outcomes.


The Joint Commission establishes its first annual National Patient Safety Goals for improving the safety of patient care in health care organizations, to take effect in 2003.


Per Congressional mandate, the Agency for Healthcare Research and Quality (AHRQ) releases the National Healthcare Quality Report and the National Healthcare Disparities Report. Together, the reports pack broad sets of performance measures, documenting the nation's progress toward improving the quality of care for all Americans.


The Hospital Compare website ( debuts, helping consumers explore how well their local hospitals care for patients. The tool – at first only cataloging seventeen processes of care quality measures in three clinical conditions – continues to expand (e.g., in 2008, it published “patient satisfaction measures”), painting an ever-more-detailed picture of care quality. Patients as customers, in turn, can better vote with their feet.

2000 to present

Media continues to turn public health threats into major ratings, featuring sensational exposes on medical errors and safety shortcomings.


Health and Human Services (HHS) Secretary Kathleen Sebelius announces the “Partnership for Patients,” a new national effort to save 60,000 lives over the next three years by stopping millions of preventable injuries and complications in patient care. To commence the initiative, HHS says it will invest up to $1 billion in federal funding toward reforms that help prevent both hospital-acquired conditions and needless readmissions. Over the next ten years, HHS estimates that the Partnership for Patients could reduce costs to Medicare by about $50 billion, and result in billions more in Medicaid savings.

Next Story »

Home »