In a new JAMA "Viewpoint," The Commonwealth Fund's Douglas McCarthy, Cathy Schoen, and David Radley discuss implications of our latest Scorecard on State Health System Performance. The scorecard's results highlight the critical role that policymakers and local health care leaders play in those states that managed to improve in key areas. Those successes, the authors say, "suggest an opportunity for physicians to join with others to exert leadership in both medical practice and the policy arena so that such gains become the norm in coming years."