Evolving Better Health Care for Every American.

Abstract

Transforming the U.S. health system requires coordinated alignment across financing, care delivery, workforce, and innovation infrastructure. Persistent fragmentation, fee-for-service incentives, administrative burden, and underinvestment in primary care continue to undermine outcomes and drive unsustainable costs, particularly for communities with limited access to preventive and social supports. This article synthesizes policy and operational strategies to advance value-based care, integrate social determinants into risk adjustment, modernize data systems, strengthen safety-net capacity, and build workforce resilience. A sequenced road map outlines short-, intermediate-, and long-term actions, led by federal and state agencies, private sector partners, and community organizations, to achieve durable improvements in quality, equity, and cost.