The overall effectiveness of a health system can be measured ina number of different ways. Health outcomes are an obvious measureand one that is tied directly to access to quality clinical care.The tracking of health outcomes involves tracking the progress ofpatients who present a chronic condition, such as hypertension, andthen measuring the results after drug therapy and lifestylechanges. Additionally, patient satisfaction is a reasonable measureof the effectiveness of a health system. Measures of healthoutcomes, patient satisfaction, and cost reduction, when coupledtogether, are significant performance indicators for monitoring theoverall effectiveness of a health system. The catalyst of U.S.healthcare reform and modernization is identifying, monitoring, andmeasuring the key performance indicators of cost, access, andquality. Introduction Measuring the cost of healthcare delivery is critical toevaluating the overall effectiveness of health systems. As noted byPorter and Lee (2013), “Improving value requires either improvingone or more outcomes without raising costs or lowering costswithout compromising outcomes or both” (p. 52). For example, thePatient Protection and Affordable Care Act (ACA) of 2010 sought totransform the U.S. healthcare system by creating synergies,efficiencies, and economies of scale that would reduce the cost ofcare delivery by spreading it across population health and diseasemanagement programs (Lathrop & Hodnicki, 2014). Accountable care organizations (ACOs) are now part ofvalue-based health services delivery and have grown in popularitysince their inception over a decade ago. Despite theofficial-sounding description, an ACO is not a legal entity; ratherACOs are voluntarily established by healthcare providers, healthplans, and hospitals to increase consumers’ access to healthservices and to reduce the collective costs of doing business. Case Report During the summer of 2018, Blue Cross and Blue Shield, theTexas-based health insurance behemoth, entered an ACO relationshipwith Baylor Scott & White Health, the largest nonprofit healthsystem in Texas. Under the agreement, in year one Baylor Scott& White would provide high-quality care to upwards of 140,000Blue Cross and Blue Shield members, establishing it as the mostsubstantial value-based care agreement with a commercial insurancecompany in the United States (Rege, 2018). Improvements in healthoutcomes for those with chronic diseases such as diabetes,hypertension, and obesity can build patients’ confidence in the ACOmodel resulting from increased quality of life, leading to higherlevels of customer satisfaction in the health system. Discussion The shift from healthcare delivery based on patient demand to amore proactive approach will require a complete commitment from allhealthcare stakeholders. Due to its ACO alignment, Baylor Scott& White Health had over 1 million lives under value-based carearrangements, and stakeholders believe that their patients willreceive high-value, coordinated, and quality care (Rege, 2018).Designing, implementing, coordinating, and managing the delivery ofhealth services can increase care and oversight across the entirecontinuum of patient care (Wexler et al., 2014). These tightercontrols at the point of service will lower costs across the entiresystem. Increasing emphasis on disease prevention will directlyaffect the rate of chronic conditions and traditional high-costillnesses. Moreover, financial risk pools will create economies ofscale as younger and healthier patients begin to purchase insuranceplan resulting from the ACA mandates. Health policies and reformssuch as the ACA demonstrate the government's meaningful efforts toreduce costs and increase access to and quality of care. Thesetypes of national standards are enforceable by government agencieswith far-reaching authority. The lower cost of medical procedurescoupled with reduced reimbursement rates from Medicare and Medicaidwill fundamentally alter health care delivery in the UnitedStates. Questions Discuss the interrelationship between cost, access, and qualityin the delivery of health services. Briefly describe the impact ofeach measure on positive patient health outcomes. Under the ACA, describe a scenario of how medical providers andhealthcare professionals work together to enhance the quality ofhealth initiatives, interventions, or outcomes. In your opinion, what role will ACOs play in the futureenvironment of value-based health services delivery? Explain youranswer by integrating an example of how an ACO can either reducecosts, increase patient satisfaction, or improve healthoutcomes.