One of the biggest challenges in health care is how to provide innovative, high technology specialty care while reining in costs at the same time. Particularly at a large academic medical center like ours, providing ever-improving care and treating the sickest of the sick often seems unavoidably expensive. But it needn’t always be. Since 2013, we have tapped our front lines — our 1,500 physicians and thousands more nurses, PA’s, pharmacists and other clinicians — for ways to improve care and reduce costs, using an innovation incubator model that adapts venture capital investment approaches to find and scale the best ideas. To date, these innovations have saved an estimated $4 million in annual medical expenses while decisively improving quality. Here’s how we did it.