Patients value the interpersonal aspects of their health care experiences. However, faced with multiple resource demands, primary care practices may question the value of collecting and acting upon survey data that measure patients' experiences of care. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) suite of surveys and quality improvement tools supports the systematic collection of data on patient experience. Collecting and reporting CAHPS data can improve patients' experiences, along with producing tangible benefits to primary care practices and the health care system. We also argue that the use of patient experience information can be an important strategy for transforming practices as well as to drive overall system transformation. N ew models of organizing, delivering, and paying for primary care seek to improve the quality of care provided to patients and the experiences of clinicians. Meanwhile, research has shown that patients place much value on effective communication with their providers, the responsiveness of clinicians and staff to their needs, and an overall sense of being treated with care and respect.

The practice of patient-centered care remains in its developmental stages-hampered, in part, by limited evidence of its effectiveness. In this article we first review available evidence on patientcentered care, such as the positive effects of engaging patients in quality improvement activities. We also point out the existence of a research gap that makes it difficult to quantify the effect of "culture change" in health care, and to attribute improvements specifically to patients' involvement. We then discuss the benefits of involving consumers in the design and improvement of products and services outside the health care industry, and we present early lessons on engaging patients to improve ambulatory care in four communities-Humboldt County, California; south central Pennsylvania; Maine; and Oregon-participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality initiative. These lessons, although early, illustrate that actively engaging patients in improving ambulatory care improves provider-patient communication, identifies and avoids potential challenges to new services, and improves provider and patient satisfaction.

Aligning Forces for Quality is the Robert Wood Johnson Foundation's signature effort to improve the overall quality of health care in targeted communities, reduce racial and ethnic disparities in care, and provide models for national reform. Activities in each of the sixteen Aligning Forces for Quality alliance communities are guided by a multistakeholder alliance of consumers, providers, and payers. To achieve goals established at the national and local levels, the alliances integrate local consumers into governance and decision making, program design and implementation, and information dissemination efforts. This article describes how the Aligning Forces for Quality investments have evolved since the initiative's launch in 2006 and offers some early lessons learned. Individual alliances have engaged consumers in numerous capacities, from serving on dedicated consumer advisory boards to representing the consumer's perspective in the design of public reports of providers' quality. The alliances' ongoing and mindful inclusion of consumers provides insights into eliciting and applying their perspectives in the pursuit of improved health care quality, value, and transparency.

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