We help design high-value, safe & efficient health care.

Core Purpose

Our mission is to solve complex health policy problems that adversely impact health care costs, quality or access. We aim to eliminate all waste and errors in health care. 

Core Values

Purpose:  We are not motivated by fame or money. Our core purpose is our goal and our reward. 

Innovation: We spur innovation while pursuing a fundamental understanding of health care. 

Impact: We create rapid and rigorous solutions to deliver lasting impact. 

Core Activities

Evidence-based Health Policy: We publish rapid, rigorous, systematic reviews to solve high impact health policy problems.

Process Improvement & Patient Safety: We integrate Lean Six Sigma, evidence-based guidelines and patient safety principles to eliminate waste and medical errors at partner health care organizations. 

Top-down & bottom-up approach to health reform

Evidence-based Health Policy


We perform systematic reviews on health policy topics of national importance and publish our findings in high-impact peer-reviewed journals. Our research is driven by an organized effort around an independent research agenda. 

Process Improvement & Patient Safety


We partner with healthcare organizations to eliminate waste and medical errors through physician-led and evidence-based process improvement. Our physician leaders are experts in Lean Six Sigma, evidence-based medicine and patient safety principles. 

Our Publications

Agarwal R, Mazurenko O, Menachemi N: High Deductible Health Plans Reduce Health Care Cost And Utilization, Including Use of Needed Preventive Services. Health Affairs (Millwood). 2017; 36(10): 1762-1768 (PubMed)

Mazurenko O, Balio CP, Agarwal R, Carroll AE, Menachemi N: The effect of Medicaid expansion under the ACA: a systematic review. Health Affairs (Millwood). 2018; 37(6): 944-950 (PubMed)

Agarwal R, Gupta A, Fendrick AM: Value-based insurance design improves medication adherence without an increase in total health care spending. Health Affairs (Millwood). 2018; 37(7): 1057-1064  (PubMed)