We Built a Sick-Care System. It鈥檚 Time to Build a Healthcare System.
We know more than ever about what helps people stay healthy and happy over a lifetime: preventive care, nutrition, movement, social connection, community support, a sense of meaning and purpose. Yet our healthcare system remains almost exclusively focused on diagnosing and treating illness after it occurs.
The Institute for the Advancement of Whole Health exists to help imagine and build something more. We convene and mobilize the people and organizations that shape healthcare to tackle a question that鈥檚 long overdue: What would it take to build a healthcare system that鈥檚 as committed to creating health as it is to treating illness?
We Spend More on Healthcare but Aren鈥檛 Getting More Health.
The United States spends more on healthcare than any peer nation, yet Americans experience poorer outcomes on almost every important measure of health and well-being.
Part of the problem lies in what our system is built to pay for. We have sophisticated mechanisms for reimbursing visits, tests, procedures, medications, and treatments once people become sick鈥攂ut far fewer for investing in the things that help people stay healthy in the first place. What would it take to build a healthcare system that moves beyond paying for healthcare to paying for health?
Spending
The U.S. spent $13,432 per capita on health care in 2023鈥攏early twice the peer-nation average of $7,393.
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Share
The U.S. devotes 17.8% of GDP to health care鈥攏early twice the rate of our peer nations.
Expectancy Gains
Since 1980, life expectancy in the U.S. has grown half as fast as peer nations, leaving Americans living ~6 years fewer聽than people in comparable countries.
Deaths
The U.S. maternal mortality rate was 18.6 deaths per 100,000 live births in 2023鈥斺�� two to three times higher than peer nations, many of which are in the single digits.
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Deaths
Americans are twice as likely to die from conditions that are preventable with timely, effective care聽compared to residents of peer countries.
Needs
About 30% of U.S. adults skip needed care due to cost鈥攖hree times higher than in most peer nations.
Whole Health is the Prescription for What Ails our Healthcare System.
is an evidence-based approach to healthcare that shifts the focus from simply asking 鈥淲hat鈥檚 the matter with you?鈥� to also asking 鈥淲hat matters to you?鈥� It looks beyond a person鈥檚 disease, diagnosis, or symptoms to understand their goals, values, priorities鈥攁nd what they want their health for. That broader understanding helps to unlock patient motivation and shape the care and support they receive.
Over the past decade, the Veteran鈥檚 Health Administration (the largest integrated healthcare system in the nation) piloted a Whole Health model of care including: peer-guided exploration of what matters most to each patient; training in wide-ranging self-care approaches like yoaga and tai chi; plus clinical care centered around each Veteran鈥檚 unique goals and needs. The results were so extraordinary that the VA formally made Whole Health its systemwide model of care, and The National Academies endorsed the Whole Health model as a blueprint for the entire nation.
But widespread adoption of Whole Health will require a fundamental shift in what our healthcare system is designed to do: from treating illness to empowering people to live healthy, meaningful lives. It will require healthcare professionals to work together across disciplines, drawing on the most appropriate conventional and complementary approaches to help each person not only get well, but stay well. It will require looking beyond clinical care to the families, communities, resources, and environments that shape health and well-being. And, of course, it will require payment models and incentives that make all of this possible.
It may sound counterintuitive that this highly personalized, more comprehensive approach could improve outcomes while also lowering costs鈥攂ut the evidence suggests it can:
Opioid Use
Patients with chronic pain in the VA Whole Health model experienced a 38% drop in opioid use鈥攐ver three times the reduction seen under standard care (11%).
Invasive Procedures
Whole Health participants had 42% fewer invasive pain procedures at 3 months and 22% fewer at 18 months, compared to control groups.
in RX Spending
Annual outpatient pharmacy spending grew just 3.5% (mental health) and 4.3% (chronic conditions) among Whole Health patients鈥攖hree to four times lower than the 12.5% and 15.8% increases among those in standard care.
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Experience
Whole Health patients reported higher likelihood to recommend the VA (+2.0 pp), more goal-aligned care discussions (+11.8 pp), better care interactions (+2.5 pp), and greater engagement in health behaviors (+2.2 pp).
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The Institute for the Advancement of Whole Health is Helping Drive the Transformation.
Whole Health will require Whole-System change, so we’re working across the system to address the structural barriers standing between what we know works and what our healthcare system is designed to deliver. Here鈥檚 what we do:
The Institute brings leaders from across healthcare and beyond together to tackle the difficult questions that determine whether Whole Health can move from promising, isolated models to widespread adoption:
- How might we pay for health rather than simply healthcare?
- What incentives need to change?
- What evidence do decision-makers need?
- What policies and standards would allow effective models to scale?
- How should success we measure success?
Our goal isn’t simply to continue the conversation about healthcare transformation. It’s to activate the people capable of making it happen.
Working with SCU’s Division of Whole Health Research and external partners, the Institute advances rigorous research into the outcomes, economics, feasibility, and scalability of Whole Health鈥攇enerating the evidence needed to inform clinical practice, organizational decision-making, payment, and policy.
As the language of Whole Health becomes more widespread, exacting definitions, standards, competencies and measures become increasingly important. The Institute works to establish evidence-informed standards that help ensure Whole Health is practiced with fidelity, rigor, and measurable impact. SCU has already taken an initial step by developing standards for becoming a Whole Health University. .
Through degree programs, certificates, continuing education, and other learning experiences, the Institute prepares clinicians, healthcare leaders, and change agents to understand Whole Health鈥攁nd to lead its implementation at scale. SCU’s groundbreaking Doctor of Whole Health Leadership is already preparing professionals specifically for systems-level transformation.
Evidence and ideas only matter if they lead to change. The Institute works to advance policies, payment models, and practices that remove structural barriers to Whole Health鈥攁nd create the conditions for proven approaches to scale.
Every year, SCU receives nearly 50,000 patient visits at , where we provide integrative, whole-person care that addresses the physical, emotional, and social dimensions of well-being.
Through a future Model Whole Health Clinic and external clinical partners, the Institute will create a living laboratory for Whole Health鈥攄eveloping, testing, and formally evaluating new models of care to expand the evidence around outcomes, feasibility, and costs while demonstrating how Whole Health can be implemented and scaled.