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Importance Transformation of US health care from volume to value requires meaningful quantification of costs and outcomes at the level of individual patients. Objective To measure the association of a value-driven outcomes tool that allocates costs of care and quality measures to individual patient encounters with cost reduction and health outcome optimization. Design, Setting, and Participants Uncontrolled, pre-post, longitudinal, observational study measuring quality and outcomes relative to cost from 2012 to 2016 at University of Utah Health Care. Clinical improvement projects included total hip and knee joint replacement, hospitalist laboratory utilization, and management of sepsis. Exposures Physicians were given access to a tool with information about outcomes, costs (not charges), and variation and partnered with process improvement experts. Main Outcomes and Measures Total and component inpatient …