Abstract
A health system is made up of the people and organizations that have the primary intent of promoting, maintaining, or restoring health. Despite similarities in building blocks and goals, health system designs vary significantly among nations. Three questions promote understanding of a health care system: (1) What patient population is included? (2) Who delivers care? and (3) How is care financed? The United States has a patchwork of health systems, which are different depending on the population served. The U.S. health systems currently face the challenge of improving access and quality of care while reducing cost. Innovations to address these challenges include organizational innovations such as patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and accountable care communities (ACCs). Some of these innovations are codified in the Patient Protection and Affordable Care Act, but recent legal and administrative challenges leave system direction uncertain.
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