Balance sheets: tools to inform changes in practice.

Balance Sheets—Tools for Translating Evidence into Practice Integrated care delivery systems have two inherent advantages over other health care organizations. First, we integrate the financing of care with care delivery. Second, our integrated care delivery systems position us to be able to collaboratively recommend and carry out changes in practice more effectively than other delivery systems. The ability to change practice comes with responsibility. We need to understand the value of a change in clinical practice—the improvement in outcomes for the resources expended—to be effective stewards of our patients’ health care resources. Because the decision to work together to change practice should be considered an opportunity cost, we need tools to understand the relative value of different clinical initiatives to focus our resources for change wisely.