Foreword 3

Executive summary 4

Introduction 5

1 Healthcare under pressure and a window of opportunity 6

  1.1 Three key current challenges 6

  1.2 Increasing pressure on healthcare sustainability 7

  1.3 How digital technologies may reshape patient journeys 9

2 Outcome-based care today: Progress without scale 10

3 Evidence of progress: Moving beyond excuses 12

  3.1 The all-or-nothing fallacy 12

  3.2 The suboptimality fallacy 13

  3.3 The complexity fallacy 14

4 Moving from incremental progress to wider transformation: How to deliver outcome-based care 15

  4.1 Clinically meaningful standardized outcomes that matter to patients 15

  4.2 Care organized around patient pathways 17

  4.3 Community infrastructure and cross-sector partnerships that address the social drivers of health 18

  4.4 Incentives and payment models aligned to reward outcomes rather than activity 20

  4.5 Digital technologies for scale: Interoperable digital and data systems for measurement, coordination and improvement 21

  4.6 Behaviours and culture that support value-driven decision-making and meaningful patient engagement 23

Conclusion: The leadership agenda to deliver outcome-based care 25

Contributors 27

Endnotes 28