We design policies to improve large systems such as health care, K-12 schooling and post-secondary education and actively assist those who wish to implement our policy recommendations. The usual policy approach blames system performance on the failings of the people and organizations comprising the system, and then attempts to directly assist or coerce them into improved performance. Such strategies often prove ineffective; they fail to recognize that organizations must perform as dictated by the incentives that the larger system places on them. Too often the cause of chronic poor performance is that these incentives reward the undesired performance and punish the desired performance. Our policy recommendations therefore do not aim at changing an organization's performance directly but rather seek to alter the structure of the larger system itself to replace incentives rewarding poor performance with strong incentives rewarding desired performance. We believe this type of system redesign should lead organizations and people in the system to improve their performance in their own interest far better than any direct policy approach could encourage or coerce.