You are the Chief Operating Officer of a large healthcare system, composed of acute, long term care, and community based organizations in addition to long term care managed care plans. Given your current studies in health policy and management, the Chief Executive Officer of this large healthcare system has requested that you prepare a high-level briefing for the system's Board of Directors in which you describe: (a)factors that have contributed to dramatic growth in health care spending over the past 50 years; and (b) how health care payment and delivery models are transforming to promote greater accountability for cost and quality in the health care system.

Please conclude your memo with your analysis of the most promising approaches for constraining cost growth while maintaining or improving quality, as well as the limitations or open questions that accompany new reimbursement and delivery models that are intended to promote "accountable care."

***The memo should be 4 pages in length. (Not including cover or reference page)

***You must use a recognizable memorandum format with subject areas segmented using sub headers. Include your institution's logo on the first page of the memo (fictitious). Be creative.