THE COMMONWEALTH FUND ONE EAST 75TH STREET NEW YORK, NY 10021-2692 TEL 212.606.3800 FAX 212.606.3500 E-MAIL cmwf@cmwf.org http://www.cmwf.org Despite spending more than any other country, the U. S. health care system is marked by significant shortcomings in efficiency, quality, access, safety, and affordability.

Health services research

THE COMMONWEALTH FUND ONE EAST 75TH STREET NEW YORK, NY 10021-2692 TEL 212.606.3800 FAX 212.606.3500 E-MAIL cmwf@cmwf.org http://www.cmwf.org Despite spending more than any other country, the U.S. health care system is marked by significant shortcomings in efficiency, quality, access, safety, and affordability. The consequences are serious: widespread disparities in health based on insurance status, income, and race; patients not receiving recommended care; and thousands of Americans dying yearly from lapses in safety.

Commentary--Achieving a high-performance health system: High reliability organizations within a broader agenda.