The U.S. health care system seeks to prevent, diagnose, and treat disease and to improve the physical and mental well-being of all Americans. Across the lifespan, health care helps people stay healthy, recover from illness, live with chronic disease or disability, and cope with death and dying. Quality health care delivers these services in ways that are safe, timely, patient centered, efficient, and equitable. Unfortunately, Americans too often do not receive care that they need, or they receive care that causes harm. Care can be delivered too late or without full consideration of a patient's preferences and values. Many times, our system of health care distributes services inefficiently and unevenly across populations. Some Americans receive worse care than other Americans. These disparities may be due to differences in access to care, provider biases, poor provider-patient communication, or poor health literacy. As in 2010, we have integrated findings from the 2011 NHQR and NHDR to produce a single summary chapter. This is intended to reinforce the need to consider simultaneously the quality of health care and disparities across populations when assessing our health care system. The National Healthcare Reports Highlights seeks to address three questions critical to guiding Americans toward the optimal health care they need and deserve: What is the status of health care quality and disparities in the United States? How have health care quality and disparities changed over time? Where is the need to improve health care quality and reduce disparities greatest? New this year, the Highlights focus on national priorities identified in the National Strategy for Quality Improvement in Health Care (National Quality Strategy or NQS) and HHS Action Plan To Reduce Racial and Ethnic Health Disparities (Disparities Action Plan). Published in March 2011, the NQS identified six national priorities for quality improvement. Consistent with past reports, the 2011 reports emphasize one of AHRQ's priority populations as a theme and present expanded analyses of care received by older Americans. Finally, this document presents novel strategies from AHRQ's Health Care Innovations Exchange (HCIE), as well as examples of Federal and State initiatives for improving quality and reducing disparities. Four themes from the 2011 NHQR and NHDR emphasize the need to accelerate progress if the Nation is to achieve higher quality and more equitable health care in the near future: Health care quality and access are suboptimal, especially for minority and low-income groups; Quality is improving; access and disparities are not improving; Urgent attention is warranted to ensure continued improvements in quality and progress on reducing disparities with respect to certain services, geographic areas, and populations, including: Diabetes care and adverse events; Disparities in cancer screening and access to care; States in the South. Progress is uneven with respect to national priorities identified in the National Quality Strategy and the Disparities Action Plan: Improving in quality: Ensuring Person- and Family-Centered Care and Promoting Effective Prevention and Treatment of Cardiovascular Disease; Lagging: Making Care Safer, Promoting Healthy Living, and Increasing Data on Racial and Ethnic Minority Populations; Lacking sufficient data to assess: Promoting More Effective Care Coordination and Making Care More Affordable; Disparities related to race, ethnicity, and socioeconomic status present in all priority areas.