This issue of the journal focuses on patient empowerment, one of the two most important issues confronting all health systems as we try to balance patient/consumer needs with the absolute necessity of controlling health care costs. While the patient needs and health care cost control are inextricably intertwined, there are financial incentives that payers can specifically place on providers (eg, decrease hospital complications) to improve health care outcomes.

This issue, guest edited by Associate Editor John Wasson together with other colleagues, focuses on the patient, today called the consumer. If we are ever able to implement accountable care, we simply must facilitate patient empowerment or engagement before we implement the typical incentives of high deductible plans: copayments, deductibles, physician/hospital tiering. Professor Wasson and colleagues, Angela Coulter and Dana Safran, expertly highlight with the other key experts in this field the tremendous amount of knowledge we already possess on measurement and cost/quality impact of empowered patients.

We continue this issue with articles on patient experiences with care in the safety net system together with a continuation of our interest on community health workers. We also publish an article on ambulatory care sensitive conditions seen in the emergency room, a phenomenon we can surely improve if we promote patient empowerment. Finally, we conclude with our commentary on the latest developments from the Republic of Texas.

-Norbert I. Goldfield, MD

Editor