“System-ness”: the key to successful health care transformation

[Value-based health care](https://www.forbes.com/sites/robertpearl/2023/07/17/value-based-healthcare-battle-kaiser-geisinger-vs-amazon-cvs-walmart/), the holy grail of American medicine, has three parts: excellent clinical quality, convenient access, and affordability for all. And as with the holy grail of medieval legend, the quest for value-based care has been filled with failure. In the 20th century, U.S. medical groups and hospital systems could — at best —
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