In our latest episode, Peter Boland wraps up our "What If They Got the Incentives Right?" podcast series with a powerful discussion on the role of measurement, transparency, and true accountability in transforming healthcare.

• Measuring What Matters: Peter Boland challenges the status quo, noting that while healthcare generates massive amounts of data, much of it measures the wrong things—often failing to produce real change for patients and communities.
• Spotlight: Meritus Health: Meritus Health in Annapolis stands out by publishing a public dashboard of health equity and disparity metrics, inviting scrutiny and real community engagement.
• Zero Defects as Equity: University Hospitals in Cleveland implemented a ‘zero defects’ policy, reducing costs and improving outcomes on a remarkable scale. Savings from eliminating low-value care were redirected into community health investments, proving it's a governance decision—not just a financial one.
• Prevention as Fiduciary Duty: SCAN Health Plan in California treats prevention not just as a values issue, but as a fiduciary responsibility. Their results—better ratings, healthier members—underscore that prevention pays back when measured on a long enough horizon.

Key Takeaways

1. Accountability at the Member Level: Aggregated data hides the truth. True impact means asking if interventions improved the lives of individual members
2. Three Principles for Change:

• Align incentives with health and pay for outcomes, not activity.
• Treat social determinants—housing, food, neighborhoods—as core infrastructure.
• Put communities in the driver’s seat; let them define priorities and metrics

1. Change Happens Locally: The most transformative work doesn't come from Washington, but from neighborhoods where collaboration drives real results

In the latest episode of More Health, Less Healthcare, Peter Boland takes us on a journey through innovative models for community health investments that genuinely listen and respond to community needs—not just on paper, but in practice. Here’s what you need to know from this insightful installment:

Peter Boland underscores the pitfalls of top-down solutions (“paternalistic and ineffective”) and explains why real change starts with asking communities what they need, not telling them what to accept. Programs must pivot based on this feedback, which, as Peter Boland notes is surprisingly rare in healthcare.

• Presbyterian Health (Albuquerque, NM): Grounded in four core beliefs—shared value of health, cross-sector collaboration, strong systems integration, and equity as a non-negotiable requirement. Their commitment to equitable, community-driven design sets a new industry standard.
• Bon Secours (West Baltimore): CEO George Kleb insists community members, not executives, set the agenda. Their “four ways of being”—asset-based, relational, collaborative, and dutiful—position the community as the true expert.
• Blue Cross Blue Shield North Carolina: Tackling social determinants of health at scale with multi-sector partnerships, and investing in training diverse rural providers.
• Hawaii Community Foundation: Pioneering “trust-based philanthropy” focused on unrestricted, responsive grants. Their process empowers grantees to use funds for what works locally—not just what fits a funder’s theory.
• University Hospitals Kansas City: Their cultural health navigator role merges interpretation, community outreach, and intelligence-gathering, bringing patient voices directly to hospital leadership.
• Vanderbilt Medical Center: By screening for health literacy, they discovered a fifth of patients didn’t fully understand medical instructions—a finding with major implications for patient outcomes.
• NYC WIC Program: First-person data collection revealed bureaucratic friction preventing eligible mothers from accessing benefits, prompting policy and process changes.

Across every example, Peter Boland observes that lasting impact comes from a relentless commitment to listening, adapting, and partnering with communities as the authority on health needs—not imposing solutions from above.

In our latest episode, Peter Boland explores a transformative question: What if employers used their full leverage to reshape employee healthcare — and invested the savings back into their communities?

Most U.S. employers have enormous purchasing power and a unique relationship with their workforce, yet often act as passive consumers of traditional insurance products. Peter Boland argues that this status quo is not inevitable — and shares examples of what’s possible when employers become proactive health investors instead.

Peter Boland breaks down the Health Rosetta model, built around eight core components:

• Transparent networks with known prices and outcomes
• Individualized health stewardship
• Advanced primary care with aligned incentives
• Active, independent plan management
• Transparency in pharmacy benefits
• Rigorous oversight of major and outlier cases
• High-performance plan design
• Transparent, aligned relationships with benefits advisors

In short: Remove conflicts of interest, align incentives, and focus on actual outcomes.

With proven models and compelling results, Peter Boland challenges employers to stop being passive purchasers. The tools and blueprints are already here; what’s needed is a proactive choice at the board level to invest wisely—and reinvest dividends back into the community.