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Innovation has become the new panacea for addressing a plethora of health care delivery issues. In this review, we examine the relationship between health technology assessment and technology commercialization in the Canadian health care system to identify opportunities to improve access and quality of health care delivery. A selected literature review identifies the causes and contributing factors to the innovation and sustainability challenges facing our publicly funded health care system. Three case examples from Alberta in Canada provide insight into the barriers and opportunities encountered at different stages of technology diffusion and commercialization, illustrating that innovation and sustainable public health care can be complementary, not incompatible. This review provides guidance to future health care policy and decision makers on advancing thinking and practice about innovation, assessment, and value.