diff --git a/domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md b/domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md
index cb4e43b4..3064d963 100644
--- a/domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md	
+++ b/domains/health/GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035.md	
@@ -19,7 +19,7 @@ The competitive dynamics (Lilly vs. Novo vs. generics post-2031) will drive pric
 
 
 ### Additional Evidence (extend)
-*Source: [[2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations]] | Added: 2026-03-15 | Extractor: anthropic/claude-sonnet-4.5*
+*Source: 2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations | Added: 2026-03-15 | Extractor: anthropic/claude-sonnet-4.5*
 
 Real-world persistence data from 125,474 commercially insured patients shows the chronic use model fails not because patients choose indefinite use, but because most cannot sustain it: only 32.3% of non-diabetic obesity patients remain on GLP-1s at one year, dropping to approximately 15% at two years. This creates a paradox for payer economics—the "inflationary chronic use" concern assumes sustained adherence, but the actual problem is insufficient persistence. Under capitation, payers pay for 12 months of therapy ($2,940 at $245/month) for patients who discontinue and regain weight, capturing net cost with no downstream savings from avoided complications. The economics only work if adherence is sustained AND the payer captures downstream benefits—with 85% discontinuing by two years, the downstream cardiovascular and metabolic savings that justify the cost never materialize for most patients.
 
diff --git a/domains/health/value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk.md b/domains/health/value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk.md
index a25838ce..18878a05 100644
--- a/domains/health/value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk.md	
+++ b/domains/health/value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk.md	
@@ -19,13 +19,13 @@ The Making Care Primary model's termination in June 2025 (after just 12 months,
 
 
 ### Additional Evidence (extend)
-*Source: [[2014-00-00-aspe-pace-effect-costs-nursing-home-mortality]] | Added: 2026-03-10 | Extractor: anthropic/claude-sonnet-4.5*
+*Source: 2014-00-00-aspe-pace-effect-costs-nursing-home-mortality | Added: 2026-03-10 | Extractor: anthropic/claude-sonnet-4.5*
 
 PACE represents the extreme end of value-based care alignment—100% capitation with full financial risk for a nursing-home-eligible population. The ASPE/HHS evaluation shows that even under complete payment alignment, PACE does not reduce total costs but redistributes them (lower Medicare acute costs in early months, higher Medicaid chronic costs overall). This suggests that the 'payment boundary' stall may not be primarily a problem of insufficient risk-bearing. Rather, the economic case for value-based care may rest on quality/preference improvements rather than cost reduction. PACE's 'stall' is not at the payment boundary—it's at the cost-savings promise. The implication: value-based care may require a different success metric (outcome quality, institutionalization avoidance, mortality reduction) than the current cost-reduction narrative assumes.
 
 
 ### Additional Evidence (extend)
-*Source: [[2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations]] | Added: 2026-03-15 | Extractor: anthropic/claude-sonnet-4.5*
+*Source: 2024-08-01-jmcp-glp1-persistence-adherence-commercial-populations | Added: 2026-03-15 | Extractor: anthropic/claude-sonnet-4.5*
 
 GLP-1 persistence data illustrates why value-based care requires risk alignment: with only 32.3% of non-diabetic obesity patients remaining on GLP-1s at one year (15% at two years), the downstream savings that justify the upfront drug cost never materialize for 85% of patients. Under fee-for-service, the pharmacy benefit pays the cost but doesn't capture the avoided hospitalizations. Under partial risk (upside-only), providers have no incentive to invest in adherence support because they don't bear the cost of discontinuation. Only under full risk (capitation) does the entity paying for the drug also capture the downstream savings—but only if adherence is sustained. This makes GLP-1 economics a test case for whether value-based care can solve the "who pays vs. who benefits" misalignment.