In this book we have provided information on how evidence is used or ignored in decisions about innovations by leaders of health systems and health insurers and by public health policymakers. This “evidence on evidence” – information about the use of evidence on nonclinical interventions – is voluminous, but with many gaps. Sometimes the evidence is encouraging about effective interventions, but often it is discouraging with nothing new found, and it is always suggestive but certainly not conclusive on processes, methods, rules, and policy interventions that might lead to health care improvement from the status quo. We are honest about this ambiguity because this study of evidence revealed the lack of rigor in health care managers’ decision-making – but it also revealed some unavoidable costs and delays of seeking perfect evidence. The book, then, is not only a wake-up call, but also a call to action toward a culture of change in how health care and health insurance leadership deal with the science that supports innovation.