The field, the farmer, the patient: what if financing could connect them all?

New research into results-based financing for regenerative farming

The soil beneath our feet and the health of people living in cities might seem worlds apart. Yet that is precisely the connection HarvestCare has been working to make — and that we spent the past year investigating systematically, together with Social Finance NL and Invest-NL.

How this research came about

Through the EIP subsidy underpinning our Agri-Health Outcome Payment Model (AHOPM), we were already exploring how food-is-medicine programmes could be financed sustainably. At our symposium Soil as the Foundation of Health in Leiden, Louise Blankensteijn of Invest NL approached us. She saw what we saw: that the agricultural side of the story — the farmer, the soil, the way food is grown — was largely absent from the financial logic of preventive healthcare. That conversation led to a concrete research project, commissioned by Invest-NL and developed in partnership with HarvestCare. The result is the report Healthy Soils, Healthy People, published in April 2026.

What we investigated

The central question was whether health-related results-based financing could contribute to a scalable business model for regenerative farmers. Results-based financing is an approach in which payment is only made once measurable outcomes have been achieved — not for effort, but for impact. That sounds straightforward, but it demands sharp answers to three questions: what health benefits does regenerative farming actually deliver, who stands to gain, and are those parties willing to pay for it?

The research unfolded in three phases: a desk review of scientific evidence, the development of a theory of change and outcomes map, and interviews with stakeholders from farming, healthcare, government and finance — including Menzis, VGZ, Rabobank, the Louis Bolk Institute, Wij.land, and the Ministries of VWS and LVVN.

What we found

The findings are promising and honest about what is still missing. Regenerative farming does deliver measurable health benefits, but not equally for everyone, and not always in ways that are immediately financeable.

The strongest evidence concerns those who live and work closest to the land: farmers, agricultural workers and local residents. Reduced exposure to pesticides, fine particulate matter and ammonia — these are effects that are measurable, scientifically substantiated, and robust enough to serve as a starting point for results-based financing. For consumers, the picture is encouraging but more indirect. Nutrient-denser crops and a healthier gut microbiome are plausible outcomes, but the causal chain is not yet strong enough to anchor a primary financing mechanism.

Conceptually, results-based financing and regenerative farming are well matched: both are oriented towards measurable system improvement rather than rewarding activity on paper. But large-scale application remains premature. Standardised KPIs, measurement methodologies and appropriate regulatory frameworks are still lacking. That makes health, for now, not a standalone income stream for farmers — but a serious, evidence-grounded added value that can be developed step by step.

What comes next

It is precisely that gradual approach that holds the most promise. The report's recommendations point towards regional pilots, starting with the health effects that have the strongest evidence base — reduced exposure to pesticides, particulate matter and ammonia. In parallel, further evidence development is needed around nutrient density and microbial diversity, including through programmes such as Soils2Guts.

The third recommendation connects directly to what HarvestCare already does: link regenerative farming to diet and lifestyle interventions. Voedsel op Recept, our Food-is-Medicine programme for people living with type 2 diabetes in Rotterdam, is exactly that bridge. It makes health outcomes concrete and measurable, and at the same time creates a reliable market for regenerative farmers.

A starting point, not a conclusion

This report is not a blueprint. It is an analytical foundation — one that documents what we know, what still needs to be proven, and which steps are realistic. For HarvestCare, it confirms that the direction is right: health and farming are not separate domains, but two sides of the same system. The soil is the foundation — of food, of the living environment, and ultimately of our health.

The full report is available to read here. Interested in collaborating or want to explore this further? Get in touch.