Abstract
High-impact health care is a new, employer-driven model that builds on existing employer-direct contracts for primary care centers of excellence and accountable care organizations. High-impact health care proceeds both cautiously and boldly. Cautiously by contracting with providers only after developing relationships with them and assessing their performance-to assure they are top performers; boldly by elevating member feedback to being a top criterion for determining which physicians remain in the network. Driven by the collective purchasing power of large employers, high-impact health care can provide employers a unique path to value-based care.