“Growing”​ a new way to pay for care

USofCare works to promote health care policy that makes people’s lives better. So what were we doing in a greenhouse for a couple days? Well, it wasn’t to grab tomatoes off the vine for dinner.

Rather than a glass building in the backyard, Deloitte Health gathered us in a big conference room in Dallas — more than 20 people from around the health care space, ranging from professionals to advocates to everyday folks. We’d all come to pursue an ambitious goal: Figuring out new and better ways to make health care better and to promote equity and put people first, focusing our efforts on the Medicaid population. 

Leaders from across the health care ecosystem — including people representing hospitals and health systems, health tech, insurers, and voices of real life, brought their minds, experience, passions, and determination — so that together we can start to build a health care system that works better for everyone. We focused our time together on figuring out better ways to pay for care. That’s because better care can result from better payment systems.

We talked about what happens when incentives — that is, payments — line up with what a person needs from their care. In short, it almost seems simple: When care focuses on people’s whole selves and payments for that care are based on the value that people get from their care, the care is better. People’s health outcomes are better too. It’s a payment model that leverages data to ensure that care is the most effective it can be and looks to proactively address health issues, which can lead to better overall health for people and increase health equity.

What happens in a Deloitte Greenhouse?

If you want to build a better health care system, folks need to come to an agreement on what that system should look like. USofCare’s years of research and listening to people tell us what they want: A system that’s affordable, dependable, personalized, and easy to navigate.

Those goals — because we know they’re truly what people want and need from the system — became the North Star for all the Greenhouse’s participants. 

We started the session by taking a high-level look at what change is possible, especially within the system’s infrastructure, delivery of care, and equity. As the day moved along, we joined small groups and explored possible innovations, as well as thinking through who could make them possible. We worked toward designing a payment model based on the actual value that people get from their care. 

The model we’d end up with included a focus on promoting equity among Medicaid beneficiaries and coordinating care for people’s entire selves. We kept digging and worked to understand what barriers might be in the way of succeeding — some of those were organizational, administrative, and policy roadblocks that the field might face as we work toward a better method of paying for care.

We learned quite a lot through our time in the Deloitte Greenhouse. One of the most important lessons we took away is that we need to focus on an individual patients’ definition of what it means to be healthy, highlighting the importance of the field prioritizing care that centers on each person’s individual needs. It’s clear that care delivery — the myriad ways we actually get care to people when they need it — has a huge impact on equity throughout the system.

What also became clear is that leaders from around the health care space realize that promoting equity through a new and better payment system will take a lot of collaborative and ongoing work. Most encouraging of all is that, despite the good amount of effort ahead of us, we share the passion for building a fairer, more equitable system. As advocates, these are the types of things that keep us going — working together to move the needle and building effective relationships with everyone at the table.

So where did we end up? Well, we did a lot of exploring to get there. Thirty-six possible initiatives rose to the top, which we could categorize into six main themes. (More on these soon!) Then we looked a little deeper to find the policy actions that could help move these initiatives forward and remove barriers to the initiatives being effective. For instance, we can advocate for policy changes that keep people from tumbling back and forth on their eligibility for Medicaid.

After all that, our USofCare and Deloitte teams regrouped at the end of the day and plotted our course from the Greenhouse toward a health care system that puts people first. Here’s a rough map of that course:

• Continue to engage this group of leaders who represent critical sectors in the health care ecosystem.  
• Identify necessary action steps to move the needle.
  • Three immediate steps toward moving that needle:
    1. We’ll publish three different documents, including a Core Framework of our suggested payment changes, along with two other pieces to support that Framework.
    2. USofCare and Deloitte will hold numerous briefings with specific stakeholders to collaborate around the model and its key initiatives.
    3. We’ll hold a larger virtual event this autumn, which will include more stakeholders to continue and build upon the momentum we fostered at the Greenhouse.
• Build on existing partnerships and create new ones so that we can move forward a model that prioritizes the needs of the Medicaid population.

Looking back at the whole Deloitte Greenhouse experience — and forward to everything that’s yet to come to life — is truly exciting. This is a great example of how we can make real change to the health care system. Convening a group of leaders across sectors to discuss a transformative topic; a new method of paying for care that puts people’s needs front and center and meets people where they are, is USofCare’s bread and butter. 

In the words of one of the leaders who participated, “I thoroughly enjoyed the diversity of leaders that convened to break through standard thinking and status quo. We will not advance equity if we continue to perpetuate static thinking. It’s rare that we are invited into a room with incredibly talented people and encouraged to think without limits to break down barriers. I am looking forward to remaining engaged.” 

This was a truly great and enlightening experience, and we are proud to collaborate with Deloitte Health on it. USofCare’s unique position within the health care space means that we get the privilege of bringing people’s voices to the conversation and making sure that the health care system of the future is one that’s affordable, dependable, personalized, and understandable — for everyone.