The System Is Not the Patient: Next Steps for Implementing Outcome-Based Care

Developed by the World Economic Forum’s Centre for Health and Healthcare with Boston Consulting Group, The System Is Not the Patient: Next Steps for Implementing Outcome-Based Care examines how health systems can accelerate the shift to outcome-based care. Across OECD countries, healthcare spending has grown faster than GDP for two decades, while health-adjusted life expectancy has stagnated or declined and up to 20% of spending remains directed to low-value care.

Outcome-based care measures success by patient outcomes relative to resources used, yet no health system has implemented it end to end. To identify practical solutions, the World Economic Forum convened expert workshops across Europe, the United States and Asia involving providers, payers, policy-makers, industry and academia. This paper argues that full system redesign, perfectly aligned incentives and flawless measurement systems are not prerequisites for progress. Instead, it highlights six interconnected priorities: standardizing patient-relevant outcomes, organizing care around longitudinal patient pathways, strengthening community and cross-sector partnerships, progressively aligning incentives with outcomes, enabling interoperability through digital and data systems, and fostering supportive cultures and behaviours.

Case studies from Spain, the Netherlands, Singapore, the United Kingdom and the United States demonstrate how these changes are already emerging. The challenge now is to connect existing building blocks into a coordinated system focused on improving patient outcomes.