Transforming Population Health — ARPA-H’s New Program Targeting Broken Incentives

This article introduces the HEROES initiative (Healthcare Rewards to Achieve Improved Outcomes), the first Advanced Research Projects Agency for Health (ARPA-H) program focused on population health. The authors outline how U.S. health outcomes continue to lag despite high expenditures, due largely to fragmented accountability and misaligned financial incentives that prioritize individual-level interventions over community-wide prevention. HEROES addresses this by providing direct performance payments to “health accelerators” coalitions of care providers, payers, nonprofits, and tech firms who take responsibility for improving a specific public health outcome in a defined geographic area. Four target domains include maternal health, cardiovascular disease risk, opioid overdoses, and alcohol-related harms. Using a standardized outcomes toolkit and pre-set metrics, the program offers scalable evaluation and rewards improvement relative to national benchmarks, encouraging equity, innovation, and sustainable investment in whole-population health.

This article introduces the HEROES initiative (Healthcare Rewards to Achieve Improved Outcomes), the first Advanced Research Projects Agency for Health (ARPA-H) program focused on population health. The authors outline how U.S. health outcomes continue to lag despite high expenditures, due largely to fragmented accountability and misaligned financial incentives that prioritize individual-level interventions over community-wide prevention. HEROES addresses this by providing direct performance payments to “health accelerators” coalitions of care providers, payers, nonprofits, and tech firms who take responsibility for improving a specific public health outcome in a defined geographic area. Four target domains include maternal health, cardiovascular disease risk, opioid overdoses, and alcohol-related harms. Using a standardized outcomes toolkit and pre-set metrics, the program offers scalable evaluation and rewards improvement relative to national benchmarks, encouraging equity, innovation, and sustainable investment in whole-population health.