During the past fifteen years, the countries of the former Eastern Bloc transformed their centrally planned, supply-driven health care systems. Modernization of service delivery required innovations in financing and insurance and the restructuring of primary care and hospital networks. This review of experiences from Central and Southeast Europe, the Baltic States, Central Asia, and the Caucasus spot lights innovative health reforms in low- and middle-income countries, including contributions to improved service delivery, access to care, evidence-based medicine, and overall improvement in health system performance.