Sarah Thomas, MS

We are in the midst of exchange implementation-the centerpiece of the affordable care act-and it seems a good time to take stock of where we are and need to go. The ACA has validated and spurred on existing efforts. We are making progress on many fronts but fundamental changes are still needed to deliver on the promise of better value.

Purchasers-employers and government programs-are primary actors for pushing for payment, benefit design, and transparency initiatives to get better value; health plans can partner.