Scaling Transformation: International Efforts to Build Innovation, Rapid Learning, Real-World Evaluation Cycles

Health systems globally are turning to value-based innovations to sustainably address population health and cost challenges. While several countries have established entities to test value-based models, the next challenge for policymakers is rapidly determining what works, under what conditions, and how to scale. Drawing from a roundtable of international innovators, researchers, and policy experts, this commentary identifies three priorities for accelerating transformation through stronger learning and evaluation. First, systems are using data to engage clinicians and patients in co-design and testing, including rapid randomized controlled trials. Second, rapid evidence generation using "good enough" data can inform implementation using mechanisms like communities of practice. Third, evaluation methodologies are assessing real-world outcomes through techniques like extrapolation to estimate long-term health and spending impacts. An international learning network could help policymakers efficiently share, test, and refine these methods to improve how evidence is generated and used to support implementation and scale.