# EP504: A Back-to-Basics Roadmap Through the Perverse Incentives to Advanced Primary Care, With Ryan Jacobs

Page: https://stenobird.com/podcast/relentless-health-value-872220/ep504-a-back-to-basics-roadmap-through-the-perverse-incentives-to-advanced-primary-care-with-ryan-jacobs
Text version: https://stenobird.com/podcast/relentless-health-value-872220/ep504-a-back-to-basics-roadmap-through-the-perverse-incentives-to-advanced-primary-care-with-ryan-jacobs.md
Podcast: [Relentless Health Value](https://stenobird.com/podcast/relentless-health-value-872220)
Published: 2026-03-26T10:30:00+00:00
Episode link: https://cc-lnk.com/EP504
Audio file: https://traffic.libsyn.com/secure/healthvalue/RHV_EP504_Ryan_Jacobs2.mp3?dest-id=197686
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JSON: https://stenobird.com/v1/public/podcasts/relentless-health-value-872220/episodes/ep504-a-back-to-basics-roadmap-through-the-perverse-incentives-to-advanced-primary-care-with-ryan-jacobs
Duration seconds: 2016

## Resource

Why Advanced Primary Care Doesn't Scale: Conflicting Incentives, Complacency, and a 3-Step Roadmap Stacey Richter interviews Ryan Jacobs (SVP Strategy and Partnerships, Marathon Health) on why evidence-backed advanced primary care (APC)—focused on managing risk, improving outcomes, and lowering costs—still isn't widespread. They argue APC struggles to scale due to two root barriers: conflicting fiduciary duties (health systems and payers driven by volume, "heads in beds," and market-power growth, while APC keeps patients out of hospitals) and a "black box of complacency," where innovators often lose to the status quo because dominant organizations can rationally avoid investing without gaining share. Jacobs offers a three-step roadmap: perform a reality-based assessment by following the money and identifying who is financially harmed by prevention; anticipate stakeholders' math by framing value as CFOs, benefits leaders, and plan sponsors do; and proceed from strategic conclusions such as direct contracting to bypass misaligned intermediaries. === LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP504 ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe 🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe 🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1 🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b 📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue === CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky http…

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