Health care spending in the United States continues to escalate; it is now nearly 18 percent of the gross domestic product. A number of major efforts across country are attempting to understand, measure, and ultimately slow the rate of spending growth. Many efforts also seek to publicly report information about price, cost, and spending. Yet each of these initiatives is hampered by the problem of defining and quantifying cost and spending, and many are trying to understand and measure economic variables in novel ways. As these measurement initiatives develop, those attempting this work almost immediately face a series of fundamental questions. Definitions matter in this effort. The varying perspectives of stakeholders do as well. In June 2011, the Robert Wood Johnson Foundation (RWJF) convened a meeting of leading experts in Washington, D.C., to discuss the difficulties of cost and spending measurement and reporting. Leading experts from health plans, employers, government and philanthropic organizations, and others sought to develop practical guidance for the field in measuring price, cost, and spending. Strategies discussed in that meeting inform this paper.