Written by a volunteer patient advisor, this issue brief provides at 50-foot view of patient engagement as seen through the eyes of various stakeholders including payers, providers, and patients. The benefits and barriers are noted, and the undeniable need for engaged patients is discussed. Many techniques and programs are reviewed including those offered from insurers, clinicians, caretakers, and community members. The overall message builds a case for why authentic patient engagement is the missing ingredient in health care if we truly want better outcomes, better health, and lower costs.