With healthcare costs spiraling out of control, and quality of care lagging behind other developed countries, there is general agreement in the U.S. that significant changes are needed in order to achieve better health outcomes at lower cost. Because there is some uncertainty about the “right” way forward, some have adopted a “watchful waiting” approach. This approach is actually very risky and hospitals and health systems may find themselves too far behind to catch up. Boards have an important role to play in leading the transition. Board members and executives need to ensure that they focus on the right issues, ask the right questions, and know when they are receiving the right answers.