NEJM Catalyst

NEJM Catalyst Practical innovations in health care delivery:

Ideas, solutions, and case studies to improve patient care and drive value in health organizations.

Health care delivery is undergoing a major transformation around quality, cost, and access. NEJM Catalyst brings health care executives, clinician leaders, and clinicians together to share innovative ideas and practical applications for enhancing the value of health care delivery. NEJM Catalyst brings insightful articles and real-life examples from a network of top thought leaders, experts and adv

isors to provide:

Practical innovations in health care delivery;

Impeccable quality and impact;

Active contributions from renowned authorities, thought-leaders, and advisors;

Independent and impartial curation; and

An exchange of ideas among executives and clinicians. NEJM Catalyst is produced by NEJM Group, a division of the Massachusetts Medical Society, located in Waltham, Massachusetts.

Our May issue includes articles, case studies, and research reports on organizational culture, leadership development, a...
04/24/2026

Our May issue includes articles, case studies, and research reports on organizational culture, leadership development, a health system merger, value-based care, value-based outsourcing, patient-reported outcome measures, fax triage, innovation and venture exposure, Covid-19 testing, and health system finances: https://nej.md/4e25iHV

How health care leaders can refresh the high-reliability organization (HRO) concept to address today’s workforce shortag...
04/24/2026

How health care leaders can refresh the high-reliability organization (HRO) concept to address today’s workforce shortages, AI integration, and complex care delivery demands - conversation with Tejal Gandhi: https://nej.md/4cDazn8

The May 2026 issue of NEJM Catalyst Innovations in Care Delivery is now live: https://nej.md/3PGPeRZ
04/24/2026

The May 2026 issue of NEJM Catalyst Innovations in Care Delivery is now live: https://nej.md/3PGPeRZ

Vanderbilt University Medical Center developed an innovative approach to value-based care by partnering with local self-...
04/23/2026

Vanderbilt University Medical Center developed an innovative approach to value-based care by partnering with local self-insured employers to deploy condition-oriented bundles designed via patient and physician input: https://nej.md/4tsjoXF

Integrating Human–AI Collaboration in ECG Analysis for Clinical Advancement https://nej.md/40Aiegn
04/23/2026

Integrating Human–AI Collaboration in ECG Analysis for Clinical Advancement https://nej.md/40Aiegn

A survey of the NEJM Catalyst Insights Council finds that leading health care organizations have pursued strategies to r...
04/23/2026

A survey of the NEJM Catalyst Insights Council finds that leading health care organizations have pursued strategies to regain financial stability since the Covid-19 pandemic, including operational efficiency and a shift to outpatient and home-based care: https://nej.md/3OlBawG

Rapid distribution of diagnostic testing and countermeasures in community settings is a persistent challenge during pand...
04/22/2026

Rapid distribution of diagnostic testing and countermeasures in community settings is a persistent challenge during pandemics. During the Covid-19 public health emergency, the Increasing Community Access to Testing, Treatment, and Response program at the U.S. Centers for Disease Control and Prevention provided free Covid-19 testing through retail pharmacies.

The program enabled timely diagnosis for uninsured individuals and maintained a robust pharmacy network with the capacity to serve the entire U.S. population. This public–private partnership model can be employed for future public health emergency response, surveillance, research, and prevention: https://nej.md/4bZQkzC

High-Reliability Organizing: Refreshing a Proven Framework for Modern Health Care Challenges - listen to or read our Q&A...
04/22/2026

High-Reliability Organizing: Refreshing a Proven Framework for Modern Health Care Challenges - listen to or read our Q&A with Executive Editor Namita Seth Mohta and Tejal Gandhi, Chief Safety and Transformation Officer at Press Ganey, who reframes HRO as “high-reliability organizing,” an active verb describing consistent performance over time across clinical, operational, and financial domains: https://nej.md/4cDazn8

Patient-reported outcome measures (PROMs) are increasingly applied in clinical practice to improve quality of care and p...
04/22/2026

Patient-reported outcome measures (PROMs) are increasingly applied in clinical practice to improve quality of care and patient outcomes. To date, however, little is known about their use for peer comparisons of performance between clinicians, which the authors refer to as benchmarking.

In this study of cataract surgeons, benchmarking was implemented through a stepwise approach: (1) Before benchmarking, each surgeon could not access their performance data or compare it with that of their peers; (2) once benchmarking began, all surgeons’ identities and individual results became visible to their peers.

This benchmarking design was intended to create a learning community free from judgment or stigmatization, drawing each surgeon into a collaborative dynamic of continuous improvement.

The authors hypothesized that surgeons within such a benchmarking community would be encouraged to modify their surgical indications, improve their patients’ average outcomes, and reduce the volume of procedures without meaningful patient benefit. Between 2021 and 2025, they analyzed a benchmarking community of cataract surgeons practicing at four institutions in France: https://nej.md/4sUa92D

The benchmarking model included voluntary participation, patient involvement, improvement cycles, and respect for patient–surgeon autonomy in clinical decision-making. Dashboards allowed surgeons to compare their PROMs, clinician-reported outcome measures (CROMs), and case-mix–adjusted results. Access to the benchmarking dashboard was supplemented through noncoercive, nonpunitive quarterly meetings with peers to discuss individual and community results, enabling improvement cycles.

The authors analyzed data from over 2600 patients with complete PROM and CROM data and found that five times more surgeons modified the surgical indications they used during benchmarking than before benchmarking.

The authors also found that only surgeons who actively consulted the benchmarking dashboard modified their surgical indications. The differences were similar when compared with performance before benchmarking.

Long-standing trends toward increased outsourcing of publicly owned facilities to private organizations have generated h...
04/21/2026

Long-standing trends toward increased outsourcing of publicly owned facilities to private organizations have generated heated debate, especially in Europe, regarding potential conflicts between ensuring quality of care and implementing cost-reduction strategies to increase economic benefits.

In this context, outsourcing to private networks with a strong commitment to VBHC may be a successful strategy for improving health outcomes and lowering costs while overcoming potential drawbacks voiced by opponents of outsourcing: https://nej.md/4bPA2uj

The authors analyzed publicly available data from 25 public hospitals in the Regional Health Care System of Madrid from 2015 to 2023, comparing quality of care, efficiency, and patient experience metrics from four hospitals outsourced to the value-based Quirónsalud Health Care Network and 22 publicly managed hospitals.

Their results provide longitudinal evidence that value-based outsourcing is associated with lower standardized inpatient mortality rates, reduced medical and surgical inpatient complications, lower average lengths of hospital stays, and higher patient experience survey scores than the results from other nonoutsourced hospitals.

Significantly more patients were transferred to outsourced hospitals than to nonoutsourced hospitals, with more than half of the patients coming from areas with worse socioeconomic status.

The authors’ findings suggest that, in the context of a regional health care system providing excellent universal coverage to residents at zero out-of-pocket cost, along with free choice of health provider, value-based outsourcing is associated with increased quality of care, efficiency, and patient satisfaction, as well as helping to reduce inequalities in access to care in areas with lower socioeconomic status.

Recent technological advances are reshaping the health care landscape and fueling innovation within and outside health s...
04/21/2026

Recent technological advances are reshaping the health care landscape and fueling innovation within and outside health systems. Physicians bring critical stewardship to this transformation by launching companies, advising start-ups, and shaping investment decisions; indeed, more than 25% of the 105 health care companies that achieved valuations of more than US$1 billion between 2015 and 2024 had at least one founder who is a clinician.

Clinical training rarely fully prepares physicians to engage in these types of initiatives. While formal educational pathways, such as Doctor of Medicine/Master of Business Administration, continue to expand, hands-on experience in evaluating and building health care businesses during training remains unusual.

The authors define innovation and venture education broadly as opportunities that equip physicians with the core skills required to move health care innovations from concept to real-world implementation. These skills — such as problem identification, user-centered design, innovation financing, and systems thinking — are widely applicable across settings and enable physicians to contribute either locally or at scale within this evolving health care landscape.

This article makes the case for integrating innovation and venture exposure into clinical training, highlights existing programs, and outlines practical pathways for institutions to help physicians cultivate these core transferable skills: https://nej.md/4sUMS0u

It is more important than ever to prepare physicians to step outside conventional clinical settings so that they can both better understand and influence the future of health care delivery, either within their practice environments or at scale.

Effective leadership is increasingly recognized as a critical determinant of organizational performance within health ca...
04/20/2026

Effective leadership is increasingly recognized as a critical determinant of organizational performance within health care systems, but funding for such programs is frequently in jeopardy as revenues fail to keep up with other expenses. Therefore, the managers of such programs should adopt rigorous methods for evaluating the impact of their work.

Despite the proliferation of leadership development programs, few institutions systematically evaluate these initiatives.

This article presents a comprehensive framework for the evaluation of leadership development, grounded in implementation science and organizational research, as applied within a large academic health care institution: https://nej.md/48gPVaT

The framework emphasizes the necessity of clear eligibility criteria, integrated data sources, and alignment with institutional strategic priorities to assess program effectiveness and support continuous improvement. A case example is presented to illustrate the application of the framework: a modular, cohort-based leadership initiative aimed at mid-level leaders.

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Innovations in Health Care Delivery

Health care delivery is undergoing a major transformation around quality, cost, and access. NEJM Catalyst brings health care executives, clinician leaders, and clinicians together to share innovative ideas and practical applications for enhancing the value of health care delivery.

Since December 2015, NEJM Catalyst has brought together a network of health care leaders to share insightful ideas and real-life examples of innovations in health care delivery, in the form of articles, case studies, quarterly events, and monthly surveys of our Insights Council.

NEJM Catalyst is produced by NEJM Group, a division of the Massachusetts Medical Society, located in Waltham, Massachusetts.