diff --git a/domains/health/gatekeeping-systems-optimize-primary-care-at-the-expense-of-specialty-access-creating-structural-bottlenecks.md b/domains/health/gatekeeping-systems-optimize-primary-care-at-the-expense-of-specialty-access-creating-structural-bottlenecks.md
index de63ebb58..be5e92483 100644
--- a/domains/health/gatekeeping-systems-optimize-primary-care-at-the-expense-of-specialty-access-creating-structural-bottlenecks.md
+++ b/domains/health/gatekeeping-systems-optimize-primary-care-at-the-expense-of-specialty-access-creating-structural-bottlenecks.md
@@ -64,4 +64,4 @@ Relevant Notes:
 - [[healthcare is a complex adaptive system requiring simple enabling rules not complicated management because standardized processes erode the clinical autonomy needed for value creation]]
 
 Topics:
-- [[domains/health/_map]]
+- domains/health/_map
diff --git a/domains/health/nhs-demonstrates-universal-coverage-without-adequate-funding-produces-excellent-primary-care-but-catastrophic-specialty-access.md b/domains/health/nhs-demonstrates-universal-coverage-without-adequate-funding-produces-excellent-primary-care-but-catastrophic-specialty-access.md
index 8b172b8ca..b8ea60d5b 100644
--- a/domains/health/nhs-demonstrates-universal-coverage-without-adequate-funding-produces-excellent-primary-care-but-catastrophic-specialty-access.md
+++ b/domains/health/nhs-demonstrates-universal-coverage-without-adequate-funding-produces-excellent-primary-care-but-catastrophic-specialty-access.md
@@ -56,7 +56,7 @@ For US policy debates, the NHS is ammunition against both extremes:
 Relevant Notes:
 - [[medical care explains only 10-20 percent of health outcomes because behavioral social and genetic factors dominate as four independent methodologies confirm]]
 - [[value-based care transitions stall at the payment boundary because 60 percent of payments touch value metrics but only 14 percent bear full risk]]
-- [[gatekeeping systems optimize primary care at the expense of specialty access creating structural bottlenecks]]
+- gatekeeping systems optimize primary care at the expense of specialty access creating structural bottlenecks
 
 Topics:
-- [[domains/health/_map]]
+- domains/health/_map
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 12f54fd65..22f34ef9e 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	
@@ -19,7 +19,7 @@ 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.