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State governments around the nation have a long history of acting as health care innovators and pioneers. With the population aging and more Americans becoming eligible for Medicaid, states are under increasing pressure to improve the quality, efficiency and affordability of the health care their residents receive. In recent years, states have responded by designing and implementing various programs to improve the performance of the health care system.

Governors play a critical role in health care transformation. Many states are identifying and working to scale local and regional programs, effectively improving individual and community health, while making health care more affordable for patients and preserving taxpayer resources. Additionally, states are leveraging those initiatives to prompt innovations across the public and private sectors.

To find the most promising initiatives and share them across the country, the National Governors Association (NGA) Center for Best Practices, the National Academy of Medicine (NAM) and the Peterson Center on Healthcare worked closely with governors, their senior staff and key stakeholders in five states—Alabama, Pennsylvania, Tennessee, Virginia and Wisconsin—to catalyze their health care transformation work and provide technical support for strategic planning and implementation. Lessons learned from state policy leaders were shared widely with states at a national meeting in Salt Lake City, Utah, October 2-4, 2015.

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