Health-care reforms in the USA and England: areas for useful learning.

Two landmark and controversial bills reforming health care in the USA and England were recently passed. Despite the different history and context to health care in both countries, there is much room for mutual learning. This paper identifies three areas relating to financing, organisation, and information technology. For example, new payment mechanisms to encourage higher quality and efficiency are being developed and tested, particularly bundled payments, pay for performance, and value-based purchasing. In the USA, new national bodies to scrutinise payments in health care and to test promising new interventions to improve quality and efficiency will have lessons for the NHS. The faster adoption of electronic health records and their use in England to assess quality is a useful lesson for the USA. The new accountable care organisations and clinical commissioning groups have much to learn from each other as they develop.