In an interview, Mark McClellan, MD, PhD, senior fellow and director of the Engelberg Center for Health Care Reform at the Brookings Institution in Washington, DC, discussed the quality initiative. There are a couple of signs that the "owners" of the currently existing models of measuring provider performance are in agreement as to which models will survive and what aspects of the different models are the most important. One is that there are now some well-developed national efforts to get a broad range of stakeholders behind consistent measures and then to endorse them for widespread use. They're currently working through the process of constructing an initial set of these measures consistently across multiple private health plans. What they're aiming for in the long term is a real patient focus on consistent quality and cost measures being available. The problem with their healthcare system isn't that they aren't spending enough on coverage. They're just not spending it in the right way.