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This brief discloses policy levers the state could use that would increase the efficiency of its health care system. It is based in part on "Saving Money or Just Saving Lives? Improving the Productivity of Health Care Spending," a forthcoming article in the Annual Review of Economics by Katherine Baicker, Amitabh Chandra, and Jonathan S. Skinner. This brief also draws on "Health Care Costs and Spending in Massachusetts: A Review of the Evidence," a chart pack assembled by the Blue Cross Blue Shield of Massachusetts Foundation in collaboration with Chandra and Josephine Fisher. It was presented at the May 15 symposium on The Cost of Health Care.