An Opening for Consumers to Get a Seat at the Table on Health System Transformation
Over the last year, I have had the opportunity to serve on behalf of Community Catalyst on the Health Care Transformation Task Force – a consortium of patients, payers, providers and purchasers working to accelerate the pace of U.S. health care delivery system transformation and inspire a greater focus on person-centered care.
Since Community Catalyst’s founding, our work and investment in meaningful consumer engagement has made it clear to us that it is fundamental to transforming the health care system. Over the years, we have learned an immense amount through our work with low-income populations, seniors, people with disabilities and advocates on the ground, and were tasked with ensuring that those voices and interests were represented through our participation on the Task Force.
The result of seven months of collaboration and discussion among the members of the Advisory Group for Consumer Priorities, which I co-chaired, recently culminated in a new multi-stakeholder, consensus-based framework, “Addressing Consumer Priorities in Value-Based Care: Guiding Principles and Key Questions.” As one of the members tasked with representing consumers and consumer advocates, I am pleased that the recommendations made by the Advisory Group were fully endorsed by the diverse membership of the entire Task Force and are present in the final white paper.
The resulting document should raise eyebrows: this is a big deal. The Task Force is comprised 42 member organizations and individuals, which includes representation from six of the nation’s top 15 health systems and four of the top 25 health insurers, as well as leading national organizations representing employers, patients and their families, and the policy community.
This white paper should open the door for consumers and consumer advocates to have an increasingly meaningful seat at the table for discussions about value-based, people-centered care. In assessing their own consumer engagement efforts, plans, providers and payers agreed to examine the following six principles:
- Include patients/consumers as partners in decision-making at all levels of care. For example, are patients/consumers included as integral partners in all aspects of health care decision-making at every level, from system-level reform design to point-of-care decisions?
- Deliver person-centered care. For example, are patients/consumers and those who support them at the center of the care team?
- Design alternative payment models (APMs) that benefit consumers. For example, do APMs achieve cost-savings only through improvements in health and health care and ensure beneficiary rights and protections?
- Drive continuous quality improvement. For example, do the health care transformation policies and practices drive continuous quality improvement?
- Accelerate use of person-centered health information technology. For example, do alternative payment and care delivery models accelerate the effective use of person-centered health information technology?
- Promote health equity for all. For example, does the health care delivery system and payment reform model promote health equity and seek to reduce disparities in access to care and in health outcomes for all?
We have seen – over and over again – how meaningful consumer engagement in public health care reform has reaped dividends. In Massachusetts, consumer advocates drove adjustments to One Care, the Massachusetts dual eligible program, to provide more accurate rates for the complex care management and service needs of low-income adults with disabilities. In Ohio, advocates shaped the State Innovation Model on Patient-Centered Medical Homes to include Patient and Family Advisory Councils, community health workers and collaboration with community-based organizations. And in California the collection of data, driven by consumer advocates, will illuminate health disparities to promote greater health equity.
And now we are seeing proactive measures and the explicit endorsement of the need for meaningful consumer engagement from private purchasers, payers and providers.
The next steps are to bring these practices from the white paper to reality through our new Center for Consumer Engagement in Health Innovation in its mission is to bring the consumer experience to the forefront of health innovation in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations.
Consumer advocates will play an equally important role as we work to engage health plans to invest time and resources to support meaningful patient and family advisory roles, to ensure purchasing contract provisions that emphasize patient-reported outcomes and to push proactive efforts to understand and address health disparities to create a better way to better health. For everyone.