Since the early 1990s, Pennsylvania hospitals and health systems have envisioned a health care system driven by the needs of the people living and working in Pennsylvania. "Pennsylvania Health Care Vision 2000," adopted in 1991, was important in bringing together disparate components of the health care delivery system to create a healthy population at an affordable cost. It spoke to hospitals’ and health systems’ belief that fundamental health care reform was necessary to address the intertwined issues of access, cost, and quality.

In the 21st century, our vision remains focused on patients and the communities in which they live. However, we believe a broader partnership that unites the health care delivery and financing systems is essential to further meet the health care needs of patients and to further serve communities. To achieve our vision for the 21st century, we see partnerships between and among patients, providers, and payors—both insurers and government.

Inherent in our health care vision for the 21st century are core values that shape the actions we believe are needed to realize our vision. The values are interrelated and interdependent. They reflect both patients’ and the broader community’s needs, and the obligation to hold providers and payors accountable for meeting those needs.

Health care in Pennsylvania must focus on patients and the communities in which they live.

To advance the health of individuals and communities and to advocate for and provide services to members who are accountable to the patients and communities they serve.

Trust is essential to achieving a healthy population at an affordable cost.

• Societal resources invested in health care are entrusted to payers and providers by the public and must be managed efficiently and effectively in meeting societal objectives.
• There must be recognition of the assets available within our communities and a commitment to use them efficiently and effectively.
• Providers and payers are publicly accountable to the citizens of Pennsylvania and must share in the responsibility of meeting health needs as determined by the those citizens.
• Patients and their families must be able to trust that providers and payers place addressing individual health needs and improving community health status as their top priorities.
• Advancement of system reconfiguration, enhancement of efficiency and effectiveness of health care resources, and improvement in health status all require collaborative partnerships.
• Community leaders have a responsibility to assure that patients, providers, and payors (both insurers and government) foster an environment to meet the health care needs of patients and their communities.

Respect for individual and organizational beliefs is critical in developing healthier communities.

• Health care delivery system transformation requires both alignment of economic incentives and professional and social values between payors and providers.
• Efforts to improve community health must recognize both community values and the importance of other community institutions—education, religion, government, and human services—in shaping those values.

Individuals must become more involved in health care decision-making.

• The role individuals play in improving and maintaining their own health status must be recognized and expanded.
• Individuals must make informed decisions regarding lifestyle choices, wellness programs, preventive care, early diagnosis and treatment, and shared decision-making regarding their health care.
• The importance of communication between patients and providers must be stressed in every health care decision.

All Pennsylvanians must have access to appropriate and necessary health care.

• All individuals must have access to appropriate and necessary health care regardless of their financial status or geographic location.
• Access to health care must extend beyond acute care to services provided along the full continuum of care.
• All communities need access to basic levels of health care to assure quality of life;Allocation of resources for health care must match the health status needs of the people being served to enable health care providers to provide appropriate care.
• Given the economic disparity that exists within the country, government must recognize its role in assuring access to care for vulnerable populations.
• An equitable distribution of health care financial accountability among all parties with an interest or stake in the full spectrum of services in the health care system—including government, employers, insurers, providers, and individuals—is needed to assure appropriate access to care.

Health care must be provided with compassion.

• An integrated continuum of care offers the best means for meeting an individual’s health needs across primary, acute, and continuing care services.
• Hospitals and health systems must work in partnership with other community institutions and components of the human services system to enhance quality of life.
• Health care resources must be used in a manner that demonstrates a positive effect on the health of patients and the quality of life at every stage of life.
• The value of health care must be measured by quality improvement, cost effectiveness, patient satisfaction, and health status improvement.

There must be sustained efforts at ongoing quality improvement and innovation in health care delivery.

• Quality improvement must move beyond institutionally-based measures of quality to assess patient experiences, both in terms of outcome and satisfaction, across the continuum of care, and to identify ways to coordinate care more effectively.
• Medical and allied health education programs are needed to continue providing an adequate supply of high quality clinical practitioners.
• Society must support medical research as a means of fostering innovation and improvement in medical practice, technology, other health care practices, and health care delivery.
• Hospitals and health systems must work with other stakeholders to develop meaningful standards and measures of quality with which health care delivery performance will be evaluated.
• Patient beliefs and values are an integral part of evaluating the quality of health care services.
• Hospitals and health systems are publicly accountable to the communities they serve and share in the responsibility of creating healthier communities with others, including public health, government, business, education, social services, religious institutions, other providers, payors, and the community itself.

The health care system must recognize and support the cultural diversity of our society.

• The health care system must be responsive to the unique needs and expectations of local communities.
• Public policy on health care must recognize local population diversity.
• Accommodating cultural diversity requires an understanding of the value of different cultural contributions in our communities.
• Health care systems need to demonstrate accountability to the communities they serve.