In our latest episode of More Health, Less Healthcare, Peter Boland tackles a fundamental question: What if the healthcare industry got the incentives right? Drawing from insights in the comprehensive Health Equity Case Studies Handbook, Peter Boland summarizes game-changing models and the powerful results that emerged when organizations shifted to pay-for-outcomes.

Key Takeaways from the Episode

• Pay for Outcomes, Not Activities:
• Most healthcare payments go toward procedures and visits, not true health improvements. Peter Boland challenges us to consider: What if we tied payment to real results, just like we do in other industries?
• Success Stories Highlighted:
• Pathways Community Hub:
• Community health workers are paid when problems are solved, not just for showing up. This model led to a dramatic increase in healthy birth weights and better prenatal outcomes.
• Houston Methodist:
• Giving doctors access to monthly, personalized data on their practice resulted in lowered hospital admissions, fewer readmissions, and millions in shared savings.
• Blue Cross Blue Shield of Massachusetts:
• Their alternative quality contract ties provider payments to patient outcomes and equity—not just volume. This approach slowed spending and improved care for all populations.
• Measuring What Matters:
• Across the board, organizations that “measure what matters and tell the truth about it” saw behavior change and improved results.

Despite abundant evidence, Peter Boland asks why the industry hasn’t widely adopted these models. The answer: it’s not a lack of information—the missing ingredient is institutional will.