Look back on 2011, and you'll likely be struck by the extraordinary number of new seeds of innovation that were sown in the health care industry. Consider:

• The health-benefits giant WellPoint purchased CareMore, an innovative West Coast delivery system that uses prevention and high-touch strategies to drastically reduce the cost of caring for frail elders.
• The Centers for Medicare and Medicaid Services pushed its innovation agenda into the provider community with programs to encourage new developments in accountable care, bundled payments, and local initiatives.
• The human resources consultant and outsourcer Aon Hewitt announced that it would create a private health insurance exchange for self-funded large group and national accounts, and then launched groups starting this past January 2012.
• A leaked document implied that Wal-Mart might be planning to become the nation's largest integrated provider of primary care services (a plan the company subsequently pooh-poohed).
• A consortium of Blues purchased Bloom Health, a company that creates private exchanges and defined-contribution programs for employers.

Meanwhile, providers started taking on greater amounts of risk, to the point of offering insurance products—some independently, and some with help from some of the largest payers in the country. And you couldn't toss a brick without hitting a PCMH pilot program. To all appearances, the country was on the verge not just of health care reform—but a health care revolution. [Read "Health reform: An overview".] Based on the headlines, the long-promised convergence of retail, insurance, health care delivery, and IT seemed just a heartbeat away.

But this is health care, a garden in which even the hardiest seeds sprout slowly or wither prematurely, and the survivors take a painfully long time to reach maturity. Think of high-deductible, consumer-directed health plans, which were supposed to create a generation of discerning, value-oriented health care consumers. Or wellness programs with their sticks and carrots to stimulate healthy behaviors. Or member engagement programs, data exchange and informatics, and many, many more. To be sure, each of these efforts is having an impact in the market. But they all took time—lots more time than we first thought.

In this year's Benefits Selling / Oliver Wyman 2012 Health Care Survey, we sought to understand what is really happening in the marketplace. [Check out the 2011 survey.] Presuming that the Patient Protection and Affordable Care Act is implemented on schedule, we are nearing the dawn of public exchanges, essential benefits and more restrictive rating rules. Is the market ready? Will these innovations make it to market in time to have an impact?