Investing in Policies That Improve Lives

12:00 PM ET Thu., Mar. 27, 2025

“ Our mission is to help make investing in what works the new normal so that government decision makers at all levels are using data and evidence to inform the outcomes they want to see to close racial gaps and improve economic opportunity.”

Hear from Patrick Carter, vice president and state practice lead at Results for America, and Zachary Markovits, vice president and local practice lead at Results for America, about how they advise government at the local, state, and federal levels to build and deploy their budgets using evidence-based data to reach effective outcomes that uplift their constituent communities.

This discussion took place at the University of Notre Dame’s Summit on the Opioids Settlement: A Pathway to Hope which focused on how to most effectively distribute the nearly $50 billion in settlement dollars to maximize the impact on our communities and citizens.

Held in August 2024, this summit brought together attorneys general from across the country to discuss best practices to proactively evaluate the efficacy of opioid abatement programs and develop strategies to best distribute the funds. Led by the University of Notre Dame’s Poverty Initiative, the summit explores how evidence-based practices can inform decision making and ensure that the Opioids Settlement best helps those victims it is meant to serve.

Speakers:

Patrick Carter, Vice President and State Practice Lead, Results for America
Zachary Markovits, Vice President and Local Practice Lead, Results for America

“Investing in Policies That Improve Lives” was an urgent and deeply practical conversation about how data-driven policymaking can shape the fight against the opioid epidemic. Featuring Zachary Markovits and Patrick Carter of Results for America, and moderated by Jim Sullivan ’93, the event offered a compelling look at how data, lived experience, and local leadership can converge to build smarter responses to one of the most pressing public health challenges of our time.

Setting the Stage: From Light Bulbs to Public Spending
Markovits opened with a lighthearted story about shopping for light bulbs—overwhelmed by options and unsure what actually worked. The metaphor stuck: governments often face similar challenges when making policy decisions without trusted tools or guidance. Carter extended the analogy, noting that trusted consumer standards like UL Labs or Wirecutter have no equivalent in many public programs—despite the far higher stakes.

Making “What Works” the Default
That disconnect is exactly what Results for America aims to change. Markovits explained their mission: to make investing in proven solutions the new normal. They work with local, state, and federal governments to define what counts as evidence, embed it into procurement and budgeting, and reward programs that deliver measurable results. Carter shared real-world examples: cities like Chicago awarding grant points for evidence-based proposals, and states like Tennessee integrating clear definitions of evidence into their budget process—with tangible improvements in student outcomes.

The Stakes: Opioids, Evidence, and Urgency
The opioid crisis brought a sharp sense of urgency to the conversation. Markovits highlighted that while 2.5 million adults in the U.S. have opioid use disorder, 9 out of 10 don’t receive evidence-based care. He posed a sobering hypothetical: if even half of opioid settlement funds were invested in proven treatments, nearly 200,000 people could reduce or stop misuse, and 90,000 lives could be saved—more than a stadium full of people.

Carter pointed to promising state-level models. In places like Minnesota and Rhode Island, grant applicants are now required to draw from federal evidence clearinghouses. Some programs even pair innovation grants with evaluation support, allowing communities to test new ideas while learning what works—and what doesn’t.

Centering Communities and Rethinking Impact
A key insight from the discussion was that evidence alone isn’t enough—it must be translated into tools that local leaders can actually use. Governments don’t need more white papers; they need support in embedding data into grantmaking, budgeting, and service design. This means redefining not only what counts as evidence, but how it’s communicated, contextualized, and applied.

Importantly, the speakers challenged the notion that rigor and community insight are at odds. The most effective public investments come from pairing empirical evaluation with the lived knowledge of people closest to the issue. Some states are already doing this—requiring grantees to submit not just quantitative results but also narratives about how programs are implemented and experienced. Innovation isn’t sidelined; it’s strengthened when paired with a commitment to learning.

Even the way impact is measured needs to be reimagined. Success shouldn’t be defined only by p-values and performance dashboards, but also by whether communities feel safer, healthier, and more hopeful. In one striking example, a neighborhood tracked its progress not through arrests or overdose rates, but through the return of birdsong—an everyday sign that public spaces had become livable again. These kinds of localized, intuitive metrics remind us that data must ultimately reflect human dignity and flourishing.

A Call to Action—Rooted in Hope
The opioid epidemic is devastating—but the moment is not without promise. With $50 billion in settlement funds on the table, there is a rare opportunity to reshape systems around what actually works. That means building funding processes that reward results, uplifting voices at every level of implementation, and investing in change that is both measurable and meaningful.

The message was clear: this is not about choosing between heart and rigor. It’s about using both—side by side—to deliver policies that save lives, strengthen communities, and restore trust in public systems. Evidence is the foundation. Empathy is the fuel. Together, they create a pathway to hope that’s grounded, strategic, and deeply human.

When Choices Overwhelm: The Light Bulb Analogy
Think choosing a lightbulb is confusing? So is deciding how to spend billions in public money. The discussion uses the “paradox of choice” we face in a hardware store as a metaphor for the barrage of options government officials face when investing in programs. Just as most shoppers have no idea what bulb is best, policymakers often struggle to distinguish what truly works from what simply sounds good.

Turning the Tide: Why Evidence-Based Funding Matters
Here’s the headline: of the $2 trillion the U.S. spends annually to improve lives, only about 2% goes to programs proven to work. The conversation calls for a massive shift—away from gut instinct and toward what the data shows actually delivers impact. Markovits and Carter argue that we need the equivalent of “Consumer Reports” for public policy—rigorous systems that help leaders make smarter, more effective choices.

From Good Intentions to Concrete Policy”
The discussion shares real examples of how “evidence first” plays out in practice. In Chicago, grants reward groups with a proven track record. In Tennessee, the budget process spells out what “evidence-based” means—and funds programs accordingly. Some states go even further, weaving evidence into the actual text of legislation to ensure strong strategies get replicated.

Saving Lives in the Opioid Crisis
The opioid epidemic drives home what’s at stake. With 2.5 million Americans struggling and tens of thousands dying each year, the discussion emphasizes that even with billions available through settlement funds, most treatment programs still lack an evidence-based foundation. If just half those dollars went to proven approaches, tens of thousands of lives—a stadium’s worth—could be saved.

Get Smart About Opioid Settlement Dollars
To make that impact real, communities need to default to evidence. That means clearly defining it, baking it into applications, laws, and budgets, and making research simple and actionable. Most importantly, it means designing systems where those on the frontlines—health workers, local leaders, families—have a seat at the table.

Follow the Money—But Don’t Get Lost
Billions in funding won’t fix anything without structure. Listeners are cautioned to avoid repeating past mistakes, like the tobacco settlement, where funds were often diverted from public health. Strong safeguards—clear standards, accountability mechanisms, and transparent allocation—are essential to prevent resources from disappearing into outdated systems or political tug-of-war.

Metrics That Matter—For the Community
Numbers matter—but people notice outcomes. In one California neighborhood, residents said they felt safe not when patrols increased, but when birdsong returned. That small detail became a key indicator of community well-being. Success isn’t always a statistic—it’s how people live and feel.

The Road Ahead: Hope, Evidence, and Action
The conversation closes with a clear message: hope isn’t enough—hope needs scaffolding. With unprecedented funds at stake, the time to act is now. Making real change means aligning policy with both compassion and rigor. It means evidence, inclusion, and deep collaboration. For Markovits and Carter, this is the new frontier of public leadership: building systems that are not just well-intentioned, but well-proven.

The Hidden Guesswork in Government Spending: “Every year, governments at all levels in the United States spend $2 trillion to improve economic mobility outcomes for people… and they often make decisions just like you did, without lots of information on what works.”
— Patrick Carter [00:03:45 → 00:04:05]
Making ‘What Works’ the New Normal: “Our mission is to help make investing in what works the new normal so that government decision makers at all levels are using data and evidence… to close racial gaps and improve economic opportunity.”
— Zachary Markovits [00:04:21 → 00:04:35]
The Life-Saving Power of Evidence:“If we were to invest just about half of the settlement funds in evidence-based treatments, the equivalent of that stadium—more than that stadium—would be alive.”
— Zachary Markovits [00:12:22 → 00:12:29]
From Research to Statute: “The legislative branch identified core components of a summer learning program from research and embedded those into statute… They said: here’s what works—we’re going to require it.”
— Patrick Carter [00:10:26 → 00:10:44]
When Birdsong Becomes a Metric: ““One of the indicators of a safe community is birdsong.”
— Zachary Markovits [00:30:33 → 00:30:36]
Evidence Built on Community Voice: “If we spend this time asking the community what they need… and then we define what we mean by evidence and build that into how dollars are shaped—you’re able to deliver on the outcomes people are really looking for.”
— Zachary Markovits [00:30:51 → 00:31:10]