Financial problems plague both higher education and health care, two sectors that struggle to meet public expectations for quality services at affordable rates. Both higher education and health care also have a complex bottom line, heavy reliance on relatively autonomous professionals, and clients who share personal responsibility for achieving successful outcomes. Each sector is pursuing an array of initiatives to deal with significant public concerns, and both continue to seek effective ways to deal with their highly complex systems and difficult environments. As someone who has both headed universities and served on the board of a health system with many clinics and hospitals, the author believes that higher education can find valuable ideas in health care--ideas that validate what some universities are already doing, and ideas that are less familiar but may have potential for universities. While higher education and health care share some important characteristics and problems, many hospitals and clinics have achieved more thorough reforms than have colleges and universities. Governance of many hospitals and clinics has become more strategic, with board discussions focusing less exclusively on budget and finance and more on aligning resources to achieve well-defined goals, including improvements in quality. Universities could benefit from revisiting the "continuous quality improvement" approach, which sectors of health care now use to pursue evidence-based, systematic improvements.