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Health and well-being are human needs and closely tied to the strength and resilience of societies and economies. This is universal. Global stakeholders across sectors - patient, government, health system, clinical, payer/employer - express common challenges about how to achieve, measure, and sustain both health effectiveness and efficiency. This panel will explore the stressors and incentives that are centering well-being as a global focus in policy, payment and care delivery. Discussion will focus on defining best metrics, identifying trends in incentives for change, and prioritization of data for decision-making at all levels. Key experience and perspectives from employer, regulator, payer and patient communities will be shared.

【Program Summary】
This program, "Well-being ecosystem creation," was held on June 28, 2025, as Agenda2025
Organised Programme during Expo 2025 Osaka, Kansai, Japan, "Health and Well-being Week." Experts from around the world, corporations, academic institutions, and healthcare insurers gathered to discuss the question: *"How can we enhance the Well-being of diverse and broad populations through the utilization of data?"*
In this session, participants shared a comprehensive definition of Well-being that goes beyond the boundaries of health and medical care, encompassing mental, social, and economic aspects. Each participant presented their approach from their respective positions to identify common challenges and visions. The moderator was Jennifer L. Bright from the International Consortium for Health Outcomes Measurement (ICHOM), and panelists included representatives from global corporations and academia.
This program succeeded in presenting participants with concrete frameworks and measures to evaluate and improve Well-being, while also presenting a vision for a "co-creation type healthcare ecosystem" that will be required by society in the future. Furthermore, the importance of continued dialogue and collaboration was strongly emphasized, particularly regarding data quality and utilization, as well as connecting the perspectives of policymakers with those of practitioners and stakeholders on the ground.

【Speaker Summary: Jennifer L. Bright】
At the opening of this session, Jennifer L. Bright presented a systematic framework on the concept of Well-being and its multidimensional measurement, providing a foundation for the discussion. She first introduced existing Well-being measurement indicators by international organizations such as the OECD and WHO, emphasizing that they include complex perspectives such as economic factors, health, education, environment, governance, and life satisfaction. She also cited the U.S. "Well-being in the Nation" framework, stressing the importance of evaluations based on individuals’ subjective states, such as distress, struggle, and thriving.
Furthermore, she touched on the activities of ICHOM, advocating for a global healthcare improvement framework centered on evaluating quality of healthcare through measurement of health health and life quality outcomes most important to patients. She emphasized that health should not simply be defined as the absence of illness but should be composed of multifaceted elements such as mental health, physical and social functioning, family relationships, and employability. She underscored that the measurement of Well-being is a common challenge for nations, corporations, and healthcare providers. alike.
Bright questioned the tendency to regard Well-being as a "soft topic," pointing out that with appropriate use of data, favorable outcomes could be achieved without increasing financial burdens. She raised the importance of asking "why" when interpreting and using data, stating that it is essential not to stop at the mere collection of numbers but to interpret them with an understanding of the background and cultural context and reflect this in policies.
Finally, she emphasized that the promotion of Well-being is not only an individual responsibility but a shared responsibility of all stakeholders, including governments, employers, healthcare providers, and insurers, stressing the need for an all-inclusive approach that involves patients and social participation to ensure relevance.

【Speaker Summary:  Jeni Chih】
Jeni Chih, Senior Director of Global Benefits at PepsiCo, shared how the company supports the health and Well-being of approximately 400,000 employees in 72 countries worldwide. Under the initiative named "Healthy Living," the company has developed a comprehensive Well-being program built around four pillars: physical health, mental health, financial stability, and connection to the community, aiming to meet the diverse needs of employees.
She particularly highlighted the importance of "care as an experience," rooted in the company's philosophy of care. Chih stated, "It is not enough to merely provide benefits; employees must feel that they are valued." She emphasized the need to consistently deliver physical, mental, and social support to achieve this. In response to the issues of loneliness, anxiety, and mental health challenges revealed during the COVID-19 pandemic, the company has also actively incorporated mental health support, communication initiatives, and programs for employees’ families.
Chih also addressed the challenge of encouraging employees to take action. She noted that even when health initiatives are in place, whether individuals act on them ultimately depends on their personal choice. She stressed, "The most effective health manager is the individual themselves. No one understands their own body and mind better than they do." Through the message that each employee is "their own superhero," she advocated the importance of self-directed health behaviors.
She also discussed efforts to provide information to non-employee dependents such as family members and spouses, as well as navigation support using technology (e.g., the "Fairy Godmother Project"), designed to deliver the right information at the right time. Her talk left a strong impression that corporate-provided Well-being should be based on "relationships" and "trust," rather than merely consisting of systems and initiatives.

【Speaker Summary: Dr. Margaret Kruk】
Dr. Margaret Kruk, who has worked for over 20 years as a global health researcher focusing on healthcare system reforms in low- and middle-income countries, presented the achievements of global health improvements to date and the challenges that remain. She first introduced the dramatic reduction in mortality achieved globally in fields such as HIV/AIDS, malaria, and maternal and child health, praising the progress made in medicine through technology and collaboration. However, she stressed that addressing the remaining health disparities is essential.
She particularly focused on the question, "What is the fundamental purpose of health systems?" Kruk proposed that a high-quality healthcare system should be based on three pillars: (1) consistently improving care, (2) earning the trust and value of the population, and (3) flexibly responding to the changing needs of the population. She argued that rather than simply expanding access, it is necessary to focus on the "quality" of the medical care provided and called for the use of indicators directly linked to actual health outcomes, such as control rates of chronic diseases (e.g., hypertension).
Kruk stated that improving healthcare quality requires reforms at the "structural level," including system design, personnel placement, and incentive structures, rather than just interventions at the field level. She introduced an example from the United States on improving responses to heart attacks, explaining that the success was only achieved through comprehensive reforms of the entire system, from community awareness to emergency systems, specialized treatment, and rehabilitation.
She also presented findings from the "People’s Voice Survey," a survey collecting feedback from citizens on healthcare systems, revealing that in many countries, younger generations and highly educated urban residents were more dissatisfied with the system. This poses the risk of losing the trust of the very groups who will become future taxpayers and supporters of the system. She emphasized that gaining citizens’ empathy and consent is essential for building a sustainable system.
Concluding her talk, she quoted General MacArthur: "No matter how beautiful the strategy, you should occasionally look at the results," reiterating the importance of operating healthcare systems based on outcomes. Her remarks pointed toward the creation of a global healthcare ecosystem that visualizes healthcare quality and builds it together with citizens.

【Speaker Summary: Nils Reich】
Nils Reich, CEO of AXA’s Global Health Business, spoke from the perspective of an insurer responsible for approximately USD 25 billion in annual medical expenditures across more than 25 countries, discussing the challenges and possibilities of realizing a sustainable healthcare ecosystem. He pointed out that despite differences in healthcare systems worldwide, common challenges have emerged, such as "medical cost inflation" and "increasing difficulty of access."
According to Reich, the rate of increase in medical costs has been running 5–7 points above GDP growth rates, a structure that is unsustainable in the long term. At the same time, demand for insurance services is increasing, particularly with strong needs from younger generations and corporate clients for "secured access." He stated that insurers have a responsibility not to simply pass on costs but to improve healthcare efficiency and effectiveness.
Reich focused on the "power of data" as the breakthrough, introducing specific examples of how his company uses its data to assess healthcare quality and identify waste. For example, he pointed out that the rate of morphine administration after knee surgery varies greatly between hospitals within the same country, suggesting that unnecessary procedures might be performed contrary to patients’ best interests. He explained that correcting such "variations" is key to simultaneously improving patients’ quality of life (QOL) and reducing costs.
He further stated that while digital technology and data utilization for optimizing care will bring significant transformations in the future, implementation requires collaboration among diverse stakeholders and a shared vision. "To achieve the greatest outcomes with the resources we have, we must reduce unnecessary procedures and focus on necessary care," he said, calling for the construction of a "win-win-win" structure in which insurers, healthcare providers, policymakers, and corporations act with a common purpose.
Reich’s remarks strongly underscored that redefining the role of insurers and adopting a data-driven approach will become increasingly important for balancing economic rationality with human-centered care.

【Speaker Summary: Daniel Erasmus】
Daniel Erasmus, speaking from the perspective of an actuary, discussed the potential for visualizing healthcare outcomes using data and designing patient-centered healthcare systems based on that data. He emphasized that the perspectives of various stakeholders in the healthcare ecosystem differ greatly: insurers prioritize cost management, healthcare institutions focus on technology adoption and maintaining patient volume, regulators emphasize the sustainability of systems, while patients care most about "improving their own health." He advocated for healthcare that is centered on patients.
Erasmus then cited the Australian healthcare system as an example, highlighting that the cross-subsidy structure—where support flows from younger to older populations—is collapsing due to aging. He also noted that while the introduction of the latest medical technologies has improved patient outcomes, the costs and increased number of procedures have driven up total healthcare spending. For example, with the introduction of robotic surgery, high-risk patients who would previously not have been surgical candidates are now included, resulting in expanded demand for healthcare.
He also pointed out that "the health status at the time of admission" has a significant impact on medical costs and outcomes, stressing the need to pay more attention to prevention and daily health management (social factors). He explained that simply ensuring adequate nutrition before surgery can significantly impact post-operative recovery, underscoring the importance of improving patients’ conditions before treatment as a perspective for making healthcare systems more efficient.
Furthermore, Erasmus explained that his company, Insight Actuaries, uses Patient-Reported Outcomes (PROs) data to show that aspects of the "patient experience," such as the quality of explanations and addressing anxiety at hospitals, affect outcomes at six and twelve months post-surgery. Even with the same medical procedures, if the relationship with the patient is good, it positively impacts recovery and self-management. Based on these findings, he stated that they are working on developing "understandable communication" using AI-based language generation, which can adapt to patients from diverse backgrounds, such as Indigenous people and the elderly.
Erasmus’s remarks compellingly indicated, from both data and practical perspectives, that the key to maximizing healthcare system outcomes lies in "co-creation centered on patients," offering valuable insights for system designers.

【Discussion Summary】
In the latter half of the session, moderator Jennifer Bright asked each panelist multifaceted questions about the possibilities and limitations of improving Well-being through data utilization, as well as challenges in practice.
First, Chih spoke about the dilemma of companies having abundant employee data but not being able to extract the "cup of drinkable water (= meaningful data)" truly needed. She stressed the importance of building trust with partners and evaluating outcomes aligned with objectives. She also highlighted the difficulty of delivering information to non-employee dependents such as family members and spouses, pointing out the necessity of individually optimized navigation.
In response, Kruk stated that feedback from patients and citizens is the key to improving systems, and the essence lies in exploring "why good/bad results occur" rather than simply conducting satisfaction surveys. She also touched on the current situation where younger generations and urban residents are dissatisfied with the system, emphasizing the importance of securing trust from the next generation.
Reich asserted that by correcting "variations" and "waste" in healthcare resources, it is possible to achieve both cost containment and improved quality of life. From a global perspective, he emphasized the significance of insurers, corporations, providers, and governments working together with a shared vision.
Erasmus stated that technological innovation is creating an environment where the individual needs of patients can be better understood, and to ensure that everyone benefits from new technologies, it is necessary to balance the quality and accessibility of outcome data. He also introduced initiatives using AI to support communication that accommodates diverse cultural and linguistic backgrounds, sharing his vision for a "patient-centered co-creation ecosystem."
Throughout the discussion, a common understanding emerged that the quality and meaning of data, as well as its interpretation in context, should be prioritized over sheer quantity. The session concluded that it is essential to focus on who the data is for, what decisions it informs, and who will use it, and that building a sustainable and inclusive Well-being ecosystem requires a common understanding and collaboration among multiple stakeholders.