As a leading medical institution in the United States, the Cleveland Clinic operates at the center of the country’s raging debate over health care. Like many peers, the clinic finds itself fighting to hold the line on costs while maintaining quality, attracting the most qualified staff, and providing access to affordable health care. But its efforts don’t stop there. Established in 1921 as a nonprofit group practice with a mission that links patient care, research, and education, the clinic has long been a crucible for experimentation and innovation.

And innovate it has, though not always without controversy. With more than 37,000 employees and annual revenues in excess of $4.4 billion, the Cleveland Clinic is leading a charge to lower the burden of disease on the country’s health care system while improving quality and patient experience. Cafeterias in the clinic’s many facilities no longer serve foods containing trans fats. Cleaning supplies have been replaced with nontoxic alternatives. What’s more, starting last September new employees aren’t allowed to smoke. Applicants are tested for nicotine, and those who test positive are provided with free smoking-cessation assistance but are not offered employment. Clinic physicians excel at technological, biomedical, and pharmacological innovation—its heart and vascular...