Outcomes-based commissioning (OBC) has proven to dramatically improve social and environmental outcomes and the efficiency of public spending in certain policy areas, However, governments around the world still face various barriers (political, technocratic, etc.) to adopt this approach. In this NAB dialogue, we will explore this issue and exchange experiences with policymakers and NAB members from countries where OBC mechanisms were successful or failed to be implemented, and discuss creative solutions to address the incentives and disincentives to adopt and scale them.