To prevent problems, upstream leaders must unite the right people (caregivers, insurers, patients). They must hunt for leverage points and push for systems change (unnecessary hospitalizations, ACOs). They must try to spot problems early (by, say, monitoring blood sugar levels). They must agonize about how to measure success—avoiding both ghost victories and unintended consequences. And finally they must think about the funding stream: how to find someone who’ll pay for prevention.
