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Delivery System Reform Tracking: A Framework for Understanding Change


The health care delivery system is changing rapidly, with providers forming patient-centered medical homes and exploring the creation of accountable care organizations. Enactment of the Affordable Care Act will likely accelerate these changes. Significant delivery system reforms will simultaneously affect the structures, capabilities, incentives, and outcomes of the delivery system. With so many changes taking place at once, there is a need for a new tool to track progress at the community level. Many of the necessary data elements for a delivery system reform tracking tool are already being collected in various places and by different stakeholders. The authors propose that all elements be brought together in a unified whole to create a detailed picture of delivery system change. This brief provides a rationale for creating such a tool and presents a framework for doing so.

Publication Details

Publication Date: June 2, 2011
Author: Laura Tollen, Francis J Crosson, Nancy Taylor, Anne-Marie J. Audet, M.D., Cathy Schoen, Alain Enthoven, Ph.D., and Murray Ross, Ph.D.

L. Tollen, A. Enthoven, F. J. Crosson et al., Delivery System Reform Tracking: A Framework for Understanding Change, The Commonwealth Fund, June 2011.


Senior Health Policy Leader, Kaiser Permanente Institute for Health Policy
Senior Fellow, Kaiser Permanente Institute for Health Policy
Executive Director, Council of Accountable Physician Practices
Vice President, The Quality Institute
Senior Scholar in Residence, New York Academy of Medicine