Policy Reform White Paper: Value-Based Outdoor Healthcare℠
Policy Reform White Paper: Value-Based Outdoor Healthcare
Transforming Health Systems through Nature, Equity, and Human Rights
Prepared by: Oak Mountain Outdoor Healthcare Research Organization
Location: Eden, Utah
Date: October 2025
Executive Summary
Modern health systems are in crisis. They are financially unsustainable, socially inequitable, and environmentally blind. Oak Mountain Outdoor Healthcare proposes a Value-Based Outdoor Healthcare℠ (VBOHC) model — a policy framework that integrates ecological environments, trauma-informed care, and value-based health delivery to improve outcomes across physical, mental, and social domains.
VBOHC redefines “value” in healthcare by expanding it beyond cost and quality to include human dignity, community inclusion, and ecological sustainability. The model establishes nature as a legitimate, evidence-based care environment and positions prevention, connection, and belonging as the foundations of human health.
1. The Need for Reform
1.1 Systemic Gaps
Current U.S. health systems:
Prioritize disease treatment over prevention.
Separate behavioral, physical, and environmental health.
Reinforce institutionalization and dependency.
Exclude cultural, spiritual, and ecological knowledge systems.
These structures create “social death” — the isolation of individuals from community and nature.
1.2 The Opportunity
Scientific evidence now confirms that nature exposure improves:
Mental health and emotional regulation.
Immune, metabolic, and cardiovascular function.
Social connectedness and resilience.
Integrating outdoor healthcare within the value-based framework can reduce chronic disease costs, improve life expectancy, and rebuild trust in health institutions.
2. The Value-Based Outdoor Healthcare Model
2.1 Definition
Value-Based Outdoor Healthcare ℠ (VBOHC) is a healthcare delivery and reimbursement model that integrates nature-based interventions within the value-based care framework, measuring outcomes across biological, psychological, social, and environmental.
2.2 Foundational Pillars
Ecological Health – Health and environment are inseparable.
Trauma-Informed Systems – Healing requires emotional safety and social inclusion.
Human Rights in Health – Autonomy, access, and dignity as measurable outcomes.
Sustainability and Justice – Green infrastructure and equitable access as public health imperatives.
3. Structural and Policy Reform
3.1 Policy Redefinition
Amend CMS and HHS definitions of “covered services” to include nature-based interventions.
Develop reimbursement codes for outdoor therapies, ecotherapy, forest rehabilitation, and community nature programs.
Establish Outdoor Healthcare as a National Preventive Health Strategy under the U.S. Department of Health and Human Services.
3.2 Regulatory Integration
Integrate outdoor health metrics into Community Health Needs Assessments (CHNA).
Mandate Environmental and Health Equity Impact Statements in health system reporting.
Recognize outdoor healthcare sites (parks, lodges, forests) as regulated therapeutic environments.
4. Clinical and Workforce Reform
4.1 Clinical Transformation
Train providers in ecological literacy, shame-sensitive care, and intergenerational trauma-informed practice.
Develop Nature-Based Clinical Pathways for chronic disease, mental health, and rehabilitation.
Include nature exposure, sleep quality, and social connection as clinical metrics in EHR systems.
4.2 Workforce Innovation
Create Outdoor Health Sites and Certifications.
Embed peer, community, and indigenous practitioners in care delivery.
Rebuild morale and meaning in the health workforce through connection with nature.
5. Economic and Financing Reform
5.1 Financing Innovation
Launch Outdoor Health Equity Bonds — blending public health, environmental, and community development funding.
Support Medicaid 1115 Demonstration Waivers to fund community-based outdoor healthcare pilots.
Introduce Value-Based Outdoor Health Incentive Payments tied to outcome metrics like resilience, mobility, and community participation.
5.2 Cost Savings and ROI
Preliminary models show that integrating nature-based preventive interventions could:
Reduce healthcare costs by 15–25% annually through chronic disease prevention.
Decrease antidepressant use and hospital readmissions.
Increase community engagement, productivity, and workforce retention.
6. Governance and Ethics Reform
6.1 Ethical Foundation
Recognize social inclusion as a clinical outcome.
Incorporate community-led governance in healthcare boards.
Establish an Outdoor Healthcare Ethics Council guided by ecological and human rights principles.
6.2 Truth and Reconciliation in Care
Acknowledge the harm caused by forced institutionalization and cultural erasure.
Create reparative initiatives supporting marginalized and indigenous populations.
Fund local land stewardship and healing projects as components of healthcare delivery.
7. Research and Measurement Reform
7.1 Outcome Integration
Measure outcomes through:
Biological: immune response, cortisol regulation, metabolic health
Psychological: stress reduction, depression/anxiety scores
Social: belonging, resilience, relational health
Spiritual: meaning, connectedness, purpose
Environmental: how the environment impacts the expression of genes
7.2 Infrastructure
Develop the Oak Mountain Biobank and Outcomes Library to standardize outdoor healthcare data.
Partner with NIH, CDC, and WHO to validate VBOHC as an evidence-based practice.
Embed research within care delivery — “learning health ecosystems.”
8. Education and Cultural Transformation
8.1 Educational Pathways
Establish Oak Mountain Outdoor Health Research Organization.
Integrate nature-based science into medical, nursing, and public health curricula.
Promote eco-literacy and community-based research for health professionals.
8.2 Cultural Reframing
Shift the public perception of care from institutional dependency to ecological belonging — where health is not received, but cultivated through relationship with people and place.
9. Implementation Roadmap
Phase
Focus
Key Actions
Phase 1
Demonstration & Research
Launch Oak Mountain Outdoor Health Lodge
pilot; publish VBOHC outcomes;
partner with HHS Innovation Center.
Phase 2
Policy Adoption
Secure CPT codes,
Medicaid waivers,
and federal recognition.
Create national Outdoor Health Network.
Phase 3
Scaling & Education and train 10,000 professionals;
establish academic partnerships;
integrate outdoor care in CMS Value-Based Programs.
10. Conclusion
Value-Based Outdoor Healthcare is not an alternative — it is an evolution.
It redefines the role of health systems from managing disease to cultivating well-being through relationship, community, and ecological integrity.
By transforming policy, redefining value, and restoring humanity to healthcare, Oak Mountain Outdoor Healthcare℠, leads a movement to heal both people and earth.
