By any measure, 2011 has been a year when the health care landscape in Rhode Island has shifted.

New leadership has been chosen at the state’s largest health insurer and its second-largest hospital system. New policies under health care reform have been put into place, including a health-insurance benefits exchange created through executive order by Gov. Lincoln D. Chafee.

A new home for the Brown University Medical School has helped to redefine the city’s Knowledge District and its opportunities to serve as a catalyst, attracting new businesses in the life sciences sector; a new information technology infrastructure for electronic health records and a health-information exchange is being built out in Rhode Island; the Prince Neurosciences Institute has its first director and established a partnership with Brown University’s Institute for Brain Science; and the purchase of Landmark Medical Center in Woonsocket, a nonprofit community hospital that had been in receivership for about three years, by Steward Health Care, a for-profit hospital system owned by a equity firm in New York City, was sanctioned by the Rhode Island Superior Court, pending state approval.

The new generation of leadership that has taken the helm at many of the Ocean State’s most venerable health care institutions is symptomatic of the changes taking place.

• Peter Andruszkiewicz replaced seven-year veteran James Purcell as president and CEO of Blue Cross & Blue Shield of Rhode Island, the state’s largest health insurer with more than 600,000 members, nearly 1,000 employees and $1.6 billion in annual revenue.

In November, Andruszkiewicz announced plans to restructure Blue Cross to streamline the company, with the goal of reducing administrative costs in 2012 to less then 15 percent of every premium dollar. As part of the restructuring, 42 employees were laid off.

Two days earlier, Blue Cross announced that, under contract provisions now in place at 10 of Rhode Island’s 11 acute-care hospitals, the health insurer, using evidence-based metrics, would provide increased financial compensation to hospitals based on high-quality patient care.