Last week I traveled to the other side of the country for a gathering of more than 500 leaders from every sector of health care — insurance executives, hospital leaders, technology experts, academics, business and union leaders as well as physicians and nurses.

Here was an array of competing interests and perspectives. With so much health care debate swirling, I did not expect agreement on much. Yet I quickly found universal objection to the American Health Care Act, the Republican bill created to replace the Affordable Care Act. The open hostility surprised me. One speaker jokingly but derisively described the new metallic tiers for benefits in the individual market as “copper, pewter, and dirt.”

The health leaders — from blue states and red states — were all scratching their heads and asking what the plan has to offer beyond tax breaks. The plan includes no mechanisms to reduce the overall cost of health care, beyond the savings that would come by removing people from the insurance rolls. I heard complaints that the plan offers almost no ways to improve the delivery of health care.

And many at the Pay For Performance Summit in San Francisco noted that efforts to reduce access to care by rolling back the Medicaid expansion and ending subsidies comes as cities and small towns struggle with repercussions of the nation’s opioid crisis. The business coalition from Kentucky, for instance, lamented that its employer members have jobs they can’t fill because so many prospective employees cannot pass drug tests.

I heard several people at the conference ask: Is the midst of a national opioid crisis the right time to make it harder for people to obtain health care? Or do we need to find ways to help people get their lives back and contribute to society and the economy?

Yet even as the national landscape of health care remains uncertain, I returned from the West Coast inspired by the overall commitment to improve health care by moving away from fee-for-service payments to payments built on value and outcomes.

I heard much discussion about how the Medicare Star Measures have driven market improvement in Medicare Advantage plans more than anything else. Everyone expects that market to balloon. And as it does, the plans will seek out the providers in their networks that help them achieve 4 or 5 stars under Medicare and look to exclude providers who bring their scores down.

Another area of agreement was the need to eliminate measures that don’t improve care for patients, as well as the need to align measures so physicians can spend more time with patients and less time checking boxes on forms.

Physicians don’t need five different ways to measure the same thing. Many called on CMS and all the health plans to align on measures. Some states are leading the charge. Hawaii, for instance, is requiring measure alignment.

We also discussed the pilots on alternative payment and delivery models driven by the Center for Medicaid and Medicare Innovation. It seems unlikely that these programs will go away, especially the ones that are working such as the Comprehensive Primary Care Initiative. Some states, such as Washington, are taking the lead and pushing to have half of all state purchased care in an alternative payment model by 2018. The employer community is working closely with the state on that goal. And Massachusetts is trying to define and improve the patient experience by charting out what “patient engagement” and “shared decision making” really mean, especially when it comes to mental health and social welfare needs.

I don’t know what will happen nationally — does anyone? — but I am gratified that health leaders around the nation are continuing to pursue creative ways to make health care work better for both payers and patients. Here in the Garden State, we can also lead by supporting and expanding models that work for patients, by engaging patients and families in meaningful ways so the care they receive meets their goals, and by aligning the measures we use to reduce administrative burdens and costs and instead focus on what really matters.