Today, health care organizations (HCOs) face a new era of "value driven health care purchasing," which emphasizes: 1) quality reporting and transparency, 2) health IT adoption, 3) pay-for performance, and 4) systems improvement. What are the defining characteristics (i.e., structures and systems) of HCOs that learn to adapt to such a dramatically changing environment? This work addresses this and other questions by focusing on one of the four areas of value-driven health care, i.e., quality reporting. A critical task for managers in complex systems has been said to be the creation of effective structures for knowledge sharing and collective learning. This work integrates complex systems theory and knowledge network theory to develop a framework for understanding the structure of effective knowledge sharing networks in HCOs. The framework is then used to evaluate knowledge sharing and learning structures of HCOs, from the perspective of their performance in quality reporting. This work should be of interest to both scholars and practitioners of health care management, including professors of health management and directors of quality improvement.