This literature review pursues two main objectives: first, it argues that research on health policy actors and healthcare systems need to be separated more thoroughly. Though there are important interactions between both fields, it is often advisable to separate analytically research on health policy actors and on healthcare systems. Second, concentrating not only on actors and institutions but also on outcomes, we suggest, is theoretically valuable, practically feasible, and policy relevant. Most studies discussed in this review concentrate either on health policy implementation or on healthcare system characteristics. Our emphasis is on extending the understanding about the outcomes of different national healthcare arrangements and whether policy reforms actually deliver their promised results. To do this, more attention to the measurement of success is required.