Health systems are changing continuously, due to powerful forces such as scientific and technical advances, social and economic conditions and demography. Change affects health systems by disrupting their internal balance, that is, the adjustment of supply and demand for healthcare. At a high level, the answer is to adopt a policy approach that covers and connects the three areas of patient experience, health outcomes and cost-effectiveness, similar to the "Triple Aim" or its numerous avatars. Closer to the action, at the level at which decisions about treatment or care are made, the current trend is to focus on the "value agenda."