Learning from Accountable Health Models in Spain


Robert Wood Johnson Foundation

Principle Investigators

Dr. Richard Scheffler, PhD
Dr. Stephen Shortell, PhD

Project Staff

Meg Kellogg, Project Manager
Núria Mas, PhD, Catalonia Region Lead
Roberto Nuno, MSc, Basque Region Lead
Ana Maria Miquel Gomez, MD, Madrid Region Lead

Project Period

May 1, 2016 – April 30, 2018


Spain has 17 Regions, which are required to provide health care for their Regional populations. Each Region manages its health care systems differently with this diversity providing the opportunity for productive innovations. The most sophisticated Regions have been pursuing integration, chronic care management, and promoting an overall culture of health for their population – but with different strategies and a different package of policies, tools, and innovations in each region. Building off of their previous research of healthcare in the Valencia region, the Berkeley team will investigate innovations and lessons from three Spanish regions: Catalonia, the Basque Region, and the Madrid Region.

It is a propitious time to investigate lessons from Spain. Payers and providers in the U.S. are facing many of the same issues that Spain has been dealing with for the last decade. These include the accountability for the health of specific populations, the roles of leadership and policy in driving change, motivating care coordination, payment methodologies, structured evaluation of best practices and the dissemination of learnings.

The project will highlight lessons for the U.S. and give influential U.S. health leaders first-hand knowledge of these lessons. Following initial site visits in 2016, the Spanish team developed briefing papers on key innovations from their respective regions topical to the U.S health system. In June 2017, five U.S. health leaders traveled to Spain to participate in learning exchange, speaking with Spanish academics, clinicians, and government officials, as well as touring various healthcare sites. These leaders included Paul Wallace, M.D. (Senior Scholar at AcademyHealth), Jerry Penso, M.D., M.B.A. (Chief Medical and Quality Officer for AMGA), Parinda Khatri, Ph.D (Chief Clinical Officer at Cherokee Health Systems), Jeffery Burnich, M.D. (Senior Vice President of Medical and Market Networks at Sutter Health Network), and Toyin Ajayi, MD, MPhil (o-founder and Chief Health Officer of Sidewalk Labs’ Care Lab). The Berkeley team, Spanish team, and U.S. health leaders will convene in Washington DC in Spring 2018 to further this exchange of ideas, with an emphasis on how these innovations can be adapted and implemented for the U.S.