A restructuring of the US National Institutes of Health (NIH) to include new institutes for “health transformation” and for research into “health outcomes”, as Michael Crow advocates (Nature 471, 569–571; 2011), is unnecessary. These would duplicate the function of agencies that, like the NIH, are already overseen by the Department of Health and Human Services.

The Agency for Healthcare Research and Quality focuses on outcomes research. The National Coordinator on Health Information Technology and the Centers for Medicare & Medicaid Services (CMS) focus on transformation. In particular, the CMS will administer US$10 billion from the 2010 Affordable Care Act for research related to sustainable cost models for health care (http://innovations.cms.gov).