There are many issues that are causing changings in the healthcare system. Population aging, rapidly increasing costs of healthcare and the growing burden of chronic disease are challenges to health systems worldwide. To meet these challenges will require new approaches to healthcare delivery and comprehensive population health management. Many states are not prepared to tackle this issue yet. The US has the most expensive healthcare system in the world with health status indicators that are only average in comparison with the less costly health systems of other countries. The pressure to provide more cost-effective care is particularly intense in the US, as it attempts to expand health insurance coverage and address serious cost and quality issues. (Shortell, 2010)
In the state of North Carolina, there is a group called NCHQA (North Carolina Healthcare Quality Alliance). Their mission is to dramatically improve the delivery of health care in North Carolina and the health of all North Carolinians. NCHQA is a collaboration of virtually all the leaders in the delivery of medical care in North Carolina. The Board of Directors consists of members appointed by the Governor and other public officials, various medical societies, insurers, the state hospital association, the North Carolina Foundation for Advanced Health Programs, and Community Care of North Carolina. It also includes representatives of academic medical centers, business, consumers, and other key players dedicated to improving care. NCHQA was initially organized under the auspices of the Governor, and now operates as an independent non-profit organization. NCHQA has three goals: • Provide leadership for the improvement of health care delivery in North Carolina. •