A fee-for-service model has dominated the U.S. health-care system for generations, contributing to an unsustainable increase in spending, whereas there has not been a commensurate increase in access to high-quality health care. The rise in the number of uninsured people led to the 2010 Health Care Reform bill that mandated implementation of fundamental changes to the Medicare and Medicaid systems. Among the topics, the panel will describe an ideal health-care system that should result in improved quality and cost savings. This new system is envisioned as a learning system that will include information technology and systems engineering. Another topic is the need to resolve duplicated services and fragmented care that demand a paradigm shift in thinking about how to deliver health care in the United States. Hospitals and providers must work together for efficiency and cost savings. Much of the cost savings is proposed to come from improved transparency of quality analytics. Transitioning to models of health-care delivery disruptive to the established fee-for-service patterns remains a challenge at all levels, from policy-makers to individual physicians. Among all the changes health-care reform proposes, culture change in expectations of health-care delivery from both providers and patients may be the most necessary and most elusive part of the evolution. The panel will also address how to develop and implement the culture in a new paradigm of health-care delivery systems.