This paper addresses the “Evolutionary purpose” theme of the SIG’s purpose statement, by getting to the root of the question “What is the organisation trying to do that is worth doing?” Healthcare organizations exist –or at least ought to exist– to improve health for patients and communities. But what is health? And what should that mean for the way we organize, provide, and pay for care?

This proposes a new definition of health: “Health is the experience of physical and psychological well-being. Good health and poor health do not occur as a dichotomy, but as a continuum. The absence of disease or disability is neither sufficient nor necessary to produce a state of good health.” And it digs into some of the implications of this definition for the goals and metrics of value-based care. Specifically, it highlights: (i) the need for patient-centered and goal-based metrics; (ii) the need to include measures of overall health status; and (iii) the need to aim for improved and preserved health status, as opposed to the impossible goal of “complete … well-being,” as called for in the WHO definition.