The health of our communities is intrinsically tied to our economic security — a big concept with a lot of implications. This book is written to promote the competency and evidence in value-based designs, a system of insurance design and incentives/disincentives that cause better health behaviors and reduce financial cost trends. Levers are performance tuners, wherein small and incremental changes profoundly change the health outcomes of communities. This book is written for employers, benefits consultants, health plans, physicians, hospital systems — anyone who makes decisions on how to influence behaviors for better health outcomes. With innovation, case studies, and actual results of dividends from the “levers” that are used, value-based designs are shown to be more than co-pay reductions for medications. Productivity is increased, unscheduled absences are decreased, and health risks are reduced. Businesses have shared the evidence; this book brings it forward.