The battle over the future of U.S. health care boils down to two monumental issues: how to provide access to high-quality care for those now largely shut out of the system and how to control rising costs.

When the major provisions of the Affordable Care Acttake effect in 2014, Massachusetts will be more than seven years ahead of the nation on expanding coverage to uninsured people. Thus, it is not surprising that partisans from across the political spectrum are using the Massachusetts health-reform law to make their points. The problem is, opinion and anecdotes are running way ahead of the facts.

For instance: Have you heard that the government has taken over health care in Massachusetts? Well, that’s false. More than 80 percent of residents who are not elderly have private insurance, and 76 percent of employers offer coverage to their workers — up five percentage points since 2007. Or that newly insured residents can’t find doctors? Also false. Everyone enrolled in the new subsidized plan for low-income residents belongs to a private health plan and has access to primary-care physicians. But isn’t health reform bankrupting the state? No. In fact, while there have been ups and downs due to the recession, overall state spending on health reform has been about what was anticipated.

Not everything is working as planned, of course, but one thing is certain: Our state is far better off now that access to reliable coverage no longer depends on a person’s job, income or health status. Less than 2 percent of Massachusetts residents are uninsured, more people have access to the care they need, and health disparities based on race and ethnicity have been reduced. Public support for reform remains high, and behind the statistics are countless people whose health, well-being and financial security have improved. So, if Massachusetts has been a laboratory for covering the uninsured, the experiment is working quite well. Looming over us now, however, is an urgent problem the law was not designed to solve: the unsustainable cost of care.

No one is in a better position to influence health-care spending than the medical professionals at the front lines, but most work within fragmented systems that are almost primitive in terms of the information technology, coordination and accountability that every other large, successful enterprise in our economy takes for granted. At the heart of the problem is the fee-for-service payment system most providers operate under, in which their earnings are based primarily on the quantity, not the quality, of their services. Although government can use laws, regulations, incentives and its considerable purchasing power to bring about change, the private sector — especially health insurers, doctors and hospitals like the ones we represent — has to take the lead through collaboration and shared responsibility.

One model for collaboration is already up and running in Massachusetts, and so far, it’s working. For the past two years, physician groups and hospitals of all sizes have joined with Blue Cross Blue Shield of Massachusetts in a new kind of contractual relationship that gives patients, providers and insurers an opportunity to make health care work more effectively and efficiently. Instead of paying primarily for the quantity of services provided, the “alternative quality contract” aligns financial incentives with what the vast majority of medical professionals want to do with their time and talents — prevent illness, improve quality of life and produce better outcomes for their patients. Data from the first year indicate this approach is producing significant improvements in areas that are closely tied to both the cost and quality of care, such as screening, monitoring and effectively managing patients’ chronic conditions; preventing hospital readmissions; and reducing the use of emergency rooms for non-emergency care.

There’s no doubt that the changes needed to control health-care spending will be unsettling for many health-care providers. They require more teamwork, communication and coordination than many are used to, along with a growing reliance on data, information systems and process improvement. The payoff, however, is that their patients will receive more appropriate, better coordinated, more personalized and more effective care — better care that is more affordable. And, frankly, it’s the only way that we can hope to extend high-quality health-care services to everyone.

Andrew Dreyfus is president and CEO of Blue Cross Blue Shield of Massachusetts. Stuart Rosenberg, a physician, is president of Beth Israel Deaconess Physician Organization LLC.