Unlocking capital for prevention to get health care out of ‘repair shop mode’

If the United States wants to build healthier tomorrows, prevention has to come first. Yet today, the system continues to pour resources into repairing avoidable disease instead of preventing it. A recent discussion among health leaders focused on how to realign incentives and unlock the full value of prevention.

Hosted by Deloitte and the Milken Center for Advancing the American Dream, the group explored the fundamental misalignment that characterizes modern health care financing. With a system focused on treating health issues as they appear, less investment and emphasis go toward prevention. This leaves significant gains in health span and potential savings on the table.

Deloitte’s research on proactive care and Medicare savings  underscores that prevention isn’t just good medicine, it’s good economics. Investing in proactive, preventive care can reduce costs, extend life expectancy, and help build healthier tomorrows across the nation.

Personal stakes, professional mission

The conversation highlighted how personal experiences with chronic conditions, delayed diagnoses, or fragmented coverage shape perspectives on prevention. These experiences inform investment strategies that look different from traditional health care capital deployment. Sustainable preventive outcomes require longer investment horizons and a view of value measured over many years rather than quarters.

The oncology bias

Cancer care illustrates the broader structural imbalance. Therapeutics receive substantial capital investment, while prevention and early detection often struggle to secure support despite clear evidence of impact. Prevention-oriented startups frequently face early funding challenges, leaving both health and economic benefits unrealized.

The data is compelling. Approximately 40% of cancers are attributable to modifiable risk factors, including smoking. Programs that make preventive action easy to access, such as employer-driven cessation initiatives, often see strong and rapid participation. How prevention is delivered can be as important as the intervention itself.

Short-term thinking, long-term costs

A major barrier that continues to slow investment in prevention is the short-term nature of insurance enrollment. High rates of plan switching shorten the return-on-investment window for payers, making it difficult to justify spending on preventive efforts whose benefits may materialize years later in another organization’s plan.

Life insurance companies have emerged as unexpected innovators, recognizing that younger generations do not want the life insurance their mom and dad have and viewing health engagement as a primary retention strategy. Some now send at-home testing kits, deliver pre-diabetes diagnoses within three days, and automatically enroll members in intervention programs, creating a prevention pipeline where traditional health care has struggled. These approaches demonstrate what becomes possible when incentives align with long-term health outcomes.

Structural shifts that could drive change

The discussion surfaced several ideas that could strengthen preventive investment across the system:

• Prevention education in elementary school. Introducing basic physiology, genetics, and health literacy in elementary school can shape lifelong habits.
• New incentives for impact investing. Standardized metrics and supportive tax structures could direct more capital toward prevention.
• A national public health prevention campaign. Modern communications and social platforms can disseminate clear and accessible prevention messages at scale.

Another idea reframed health as a role every person holds, complete with training, resources, goals, and incentives. Under this model, technology and artificial intelligence could operate as a type of health dividend, channeling efficiency gains toward tools and support that encourage healthier daily behaviors.

Community-level solutions

Promising work is already underway at the community level. Community health workers equipped with data and benefits information are connecting people to services they may not otherwise use. Workforce innovations are training experienced family caregivers for professional roles. New models are expanding access to specialized care, such as menopause support, in areas where traditional providers are limited.

As consumers increasingly “vote with their feet” around prevention, the capital markets and policy structures that enable prevention must evolve to meet them. The question isn’t whether prevention pays—it’s whether investors and policymakers will create the conditions for it to flourish.

Unlocking those conditions will strengthen communities, support families, and build a more resilient system that is capable of truly building healthier tomorrows.