Help us design a low-cost, high-quality health system for the future



Health care needs fixing. Rising costs are unsustainable and quality problems are pervasive. Even as the national health care policy debate rages on, we must identify new designs for care and payment to address the crisis. At IHI's 21st Annual National Forum on Quality Improvement in Health Care in Orlando, Florida (December 6-9, 2009), we will conduct a minicourse on this topic (“Better Care – Lower Cost”) and we need your help.

Building on lessons from the IHI Triple Aim initiative and other projects, this day-long session will explore a proposed design for a care system that serves a population of 500,000 people. The design will knit together known best-practice components and theoretically-grounded innovations not yet fully tested. Design targets will be presented, including clinical outcomes at least as good as the top decile of US health care systems, continually improving health status in the population, and per capita costs 10% below the current lowest cost decile of hospital service areas in the US, with equal access for all in the population. Participants will advance the proposed design with their critiques and suggestions.

As we develop this course, we want to hear from you. Over the next two months, this space will serve as an open forum and repository for new ideas, both tested and untested (though we’d love to hear as many tested ideas as possible). We will continue to update the blog with specific questions, provocations, and our own feedback on what you provide. We hope that we will discover models, designs, and ideas we never dreamed of. We are confident that the solutions to our current health care problems are out there, in your daily work. Please share with us and help us design a rational, low-cost, high-quality health care system for the future.


Thank you,

Don Berwick & Tom Nolan


Don Berwick, MD, MPP
President and CEO
Institute for Healthcare Improvement

Tom Nolan, PhD
Associates in Process Improvement
IHI Senior Fellow

Tuesday, October 27, 2009

For an average American community with 500,000 people, what new investments in health care and health status improvement would have the highest financial return on investment, while improving care and health, over a five-year period?

Wednesday, September 16, 2009

To get things started, we ask that you respond to the following question:

In an average American community with 500,000 people, what three changes in the health care system (organizations, resources, personnel, etc.) would contribute most to simultaneously reducing the per capita costs of care and improving care outcomes and health status?