As a new era in US health care begins, the question remains of how best to deliver value to the system. Harvey Fineberg, president of the Institute of Medicine, has for years studied the issue of optimizing performance without compromising the quality of care. The Institute, an independent research organization, provides advice on health issues to decision makers and the US public, and developed research and reform priorities in the run-up to the recent legislation. In this video interview, Fineberg discusses the fissures in the system, the incentives needed to make reform stick for hospitals and patients alike, and the imperative for recalculating the value equation in health care. McKinsey Publishing’s Bill Javetski conducted the interview in Washington, DC.