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.

Peter Boland dives deep into the transformative power of community-driven housing investments and how shifting incentives—and power—can radically improve health equity.

Featured Discussions

Healthy Homes Des Moines

• Tackling childhood asthma and allergies at the source, this program goes directly into homes, identifies environmental triggers, and provides meaningful repairs and supplies. The lesson? Fix the environment, not just the patient.

The SPARC Initiative in Oakland

• Through collective action from over 500 local stakeholders, SPARC is moving affordable housing and anti-displacement efforts forward by putting decisions in the hands of residents. Real systemic change: the City of Oakland now rewards developers who partner with the community.

Bon Secours' Audacious Shift in Baltimore

• In one of the boldest moves yet, Bon Secours sold its century-old hospital and reinvested funds to build stable housing, educational spaces, and job opportunities. Their philosophy: work for the community, not just with it.

Key Takeaways

• Community is the True Unit of Intervention. Programs deliver better results when residents decide what's needed and where investment goes.
• Structural Change Beats Status Quo. Changing local government and health system policies shifts real power to those most affected.
• Tangible Returns. Investments in stable housing yield social returns that rival, if not outperform, traditional financial instruments—and improve health in the process.

Empowering communities isn’t just a theory—it’s happening now, and it’s changing lives. Be sure to catch Peter Boland's insightful analysis and real-world examples by listening to the full podcast.

Welcome back to More Health, Less Healthcare with Peter Boland. In this, we dive into why housing is far more than just a place to live—it's a clinical intervention that can shape the health of entire communities.

Key Takeaways

• Treating Neighborhoods as the Patient:

Peter Boland explores how Nationwide Children’s Hospital in Columbus redefined its mission, tackling intergenerational poverty by viewing the community itself as the patient. Investing in housing revitalization led to a 20.8% drop in ER visits and a 12.7% reduction in hospital admissions in targeted neighborhoods.

• Institutional Investment Over Charity:

Both Nationwide Children’s and Boston Medical Center demonstrate the power of allocating real capital—not just charitable donations—toward social infrastructure. Boston Medical Center devoted its entire $6.6 million Determination of Need fund to housing initiatives, securing long-term stability for patients with chronic health issues.

• Integration as Prevention:

Blue Cross Blue Shield of Minnesota’s Center of Prevention illustrates how scaling institutional efforts—integrating affordable housing, food access, and tobacco cessation—can transform both health outcomes and communities.

Why It Matters

Short-term thinking doesn’t move the needle on health equity or chronic disease. As Peter Boland puts it, “Institutions need to change, not people.” Long-term, strategic investments in housing create real and measurable health improvements.

In our latest episode, Peter Boland dives deep into the fascinating and urgent topic of Food as Medicine—a movement proving that changing what's on our plates can save both lives and dollars.

Key Takeaways

• Geisinger Fresh Food Pharmacy
• Peter Boland highlights that Geisinger’s program for type 2 diabetes achieved an 80% reduction in healthcare costs—dropping from $240,000 to just $48,000 per patient. Patients also saw improved HbA1c, lower BMI and blood pressure, and 10–50 pounds in weight loss.
• Boston Medical Center’s Comprehensive Approach
• The first hospital in the U.S. to fully integrate food as medicine, Boston Medical Center serves 7,000 people monthly—including a robust food pantry, rooftop farm, and teaching kitchen. Their efforts go further by embedding legal assistance to help patients with housing, utilities, and benefits issues.
• Cleveland Clinic’s Group Appointments
• Using shared medical appointments, patients support each other through lifestyle changes addressing root causes of chronic disease. Not only does this model increase efficiency, but the social reinforcement leads to better outcomes and reduced hospitalizations.

“Food is medicine and the industry’s continued reluctance to treat it that way is costing money and lives at the same time.” — Peter Boland

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.

In this episode, Peter Boland zooms out to examine why maternal health outcomes in the U.S. are a direct result of the systems and policies we build, not random chance. Too often, policy treats pregnancy as a brief event—missing the reality that maternal health is a long-term continuum stretching from pre-pregnancy, through birth, and into the year after.

It’s not enough to offer coverage on paper or just measure outcomes—someone has to be responsible for improving them. Tying incentives, contracts, and regulations to real results is key.

Listen to the episode for the full story on how smarter policy can save lives and deliver real value—financially and in human well-being.