What We Learned At Our Inaugural Leadership Council Retreat

At United States Of Care, we are committed to building a better health care system. With events like this, we are listening to experts, thought-leaders, and everyday voices to provide strategic guidance and innovative solutions to big problems. Throughout the vibrant discussion we found key themes and ideas that will help deliver an affordable, dependable, personal, and understandable health care system for all. The time is now, and this discussion provided key insights to inform our path forward.

Emily Barson, Executive Director of United States of Care 

Our Voices

In order to get real, people-centered results, United States of Care collaborates with policymakers, thought leaders, entrepreneurs, patients, providers, and everyday people. In April, we convened a group of our Leadership Councilmembers to think through smart, people-centered policy changes for the future of our health care system. This report includes the ideas, feedback, and key elements from those discussions. 

Our Attendees

• Members of our Founders Council: The Founders Council is one of the broadest groups of national health care experts throughout the field and thought leaders who provide guidance and who can leverage their influence for change.
• Members of our Entrepreneurs Council: The Entrepreneurs Council consists of leading executives who combine transformational thinking with practical solutions and the real-world success necessary to solve our most substantial health care challenges.
• Voices of Real Life: Our Voices of Real Life are from a variety of backgrounds and have diverse experiences with the health care system. They come together on a volunteer basis to guide and advise USofCare’s work of making health care policies that better serve us all, with a specific eye toward those who are more likely to be affected by policies and practices that keep health care out of reach.
• Members of our Hospital Leadership Council: Our Hospital Leadership Council is a diverse set of nonprofit hospitals who provide technical and strategic insights that ultimately develop solutions to make the health care system better.

Our Goals

This retreat aimed to identify and build out solutions based on people’s shared and diverse needs to build a better and more equitable health care system in the wake of the pandemic. To work toward that vision, USofCare centered the discussion around these four goals, identified based on the needs of people:

1. Affordability – Make health care more affordable: We hear from people across the country that the cost of health care is too high — even before the pandemic disrupted the economy. At USofCare we are committed to creating a system where people have certainty that they can afford their health care.

2. Dependable coverage – Provide security, certainty, and freedom in coverage: In good times, health care coverage provides certainty and flexibility for families across the country. But life altering events — like job loss, illness of a loved one, or relocation — can threaten that coverage and destabilize families. USofCare hopes to find people-centered solutions to deliver a system where people have the security and freedom that dependable health care coverage provides as life changes.

3. Personalized care – Expand personalized care: Every patient’s needs are different and a one-size-fits-all approach to care just doesn’t work for most people. Personalized care, built to fit a patient and family, will deliver better outcomes for everyone involved. USofCare is committed to crafting a system where people can get the personalized care they need, when and how they need it.

4. System navigation – Simplify our system for patients and providers alike: Finding affordable coverage and keeping families healthy is hard enough. Working families and providers alike shouldn’t have to jump through hoops in order to navigate a complicated system just to get and provide care. USofCare aims to simplify our health care system and make sure people experience a health care system that’s understandable and easy to navigate.

The Discussion

At our Leadership Council Retreat, we convened a set of diverse voices to outline a path forward to achieve our goal: a better health care system that works for everyone. USofCare used data, research, and policy proposals to drive the discussion. Through data-driven breakout group conversations, USofCare dove deeper into the problems facing patients, providers, and our system as a whole. Each goal — affordability, dependability, personalized care, and system navigation — received a breakout room. 

What We Know

Based on our qualitative research, polling, and focus groups, we centered the discussion with our four goals in mind. Below are some of our research data that we shared with participants to inform our discussion:

• People express a high level of fear about the dependability of their health care coverage. In our November 2020 national poll, 68% expressed a concern about people close to them losing insurance because of job loss.
• Cost is the main source of anxiety when it comes to health care. All sorts of costs (premiums, deductibles, surprise bills, prescription prices, etc.) are major sources of concern.
• Support for virtual care is high, with 87% reporting positive virtual care experiences and 72% appreciating the ease of scheduling and not having to leave their home.
• People put an immense amount of time into figuring out their own care — from understanding their coverage, to selecting the right provider, to attempting to get ahead of costs and upcoming bills.

For this discussion, USofCare included a variety of potential solutions for discussion. From specific proposals to broad topics, each discussion was informed by data, research, and feedback from our partners.

Key Findings

From each discussion, common themes and consensus emerged on myriad topics. Each key finding will better inform a path forward to a more affordable, understandable, people-centered, and equitable health care system.

• We need to learn from the ways the COVID-19 pandemic upended the health care system: The ongoing global pandemic upended much of society and our health care system. As the country worked together to get through its darkest days, the health care system made adjustments and new problems and solutions arose. 
  • Virtual care is helpful and improves comfort for both doctors and patients, expands accessibility and affordability, but it is not a silver bullet. The pandemic caused providers and patients alike towards remote care, but with the new delivery method came new challenges.
    • Though virtual care can bring down costs for patients and providers and may allow for more personalized and accessible care, it could also become less equitable because of the technological burden placed on patients — especially for those people who have disabilities.
  • Job-connected health insurance drives uncertainty. At an individual level, insurance that’s attached to a person’s employment is a continuous stressor. But during turbulent times for the entire nation, like during COVID-19, an economic crisis can further compound the uncertainty for a country where people’s health care is tied to their job.
  • Many policy choices were made to expand coverage during the pandemic to  help address uncertainty among the people who needed coverage the most. Beyond the pandemic, these policies should be expanded and extended to deliver more options. For example, providers and patients agreed that expanding COBRA, Medicaid, CHIP, and marketplace eligibility were beneficial — that they allowed both parties the space and time to address uncertainty without sacrificing coverage during a pandemic. In addition, policymakers at the federal, state, and local level need to work with businesses and providers to  address challenges and uncertainties people experience when they transition between coverage options.

• Patients, small businesses, and providers crave more transparency and standardization to create a more navigable health care system. 
  • Creating more transparency and simplicity in language for patients about their care is a strong desire for most people. Health care and the language used to discuss that care can be complicated. Many spend a significant amount of time figuring out exactly what care they’re receiving and what they are paying for. Simpler processes and nomenclature for patients and providers alike would increase accessibility and affordability. 
  • Providers and patients need more standardization and optimization of data sharing. Getting patients and providers on the same page can be difficult. By allowing for more data sharing between doctors, caregivers, and patients, we can deliver more cost efficient, holistic, and transparent outcomes for patients. Simple fixes, like allowing for patient-driven note sharing, can have large impacts.
  • Medicare is a popular and effective program that delivers quality, affordable care for those eligible. Simplifying the process to enroll is an easy way to increase equity in our system.

• Despite improvements in accessibility, barriers to mental health care remain. Virtual care increased accessibility and affordability for mental health care, but a crisis still rages. For a number of people, quality and affordable mental health care remains out of reach. Stigma and inaccessibility continue to inhibit patients from seeking the care they need. Virtual care offerings are an improvement, but privacy and technology concerns remain — especially in underserved and diverse communities. Increasing access and decreasing the stigma around mental health care through effective communication about options will allow providers to treat patients more holistically and address both physical and mental illness.

• Language and cultural barriers are inhibiting equity across the health care system and we need to think critically about strategic partnerships to break down those barriers. In order to improve equity in underserved communities, providers and allied organizations need to meet these communities where they are. There is not a one-size-fits-all solution and each community should drive the solution that works best for them. That means partnering with community organizations to provide services and care on those communities’ terms. Partnering with faith-based organizations, tribal governments, and others will help close cultural and language gaps to access the care that is needed.

• The current system is working for some and change cannot disrupt the things that work for patients, providers, and businesses. Incremental change is the best and most effective path forward. Despite its many flaws, the current health care system is delivering care to some in an affordable and accessible way. Disrupting the care delivery model for patients and providers who enjoy their care now will risk creating a new barrier to much-needed change. 

Our Path Forward

Our goals are clear: building a people-centered, accessible, affordable, equitable, and understandable health care system. Success will require different paths forward. What works for one community might not work for another and creating a feedback loop will allow policymakers and stakeholders to learn important lessons. To start down the path toward achieving our goals, we will:

• Combine this retreat’s findings with our qualitative and quantitative research and integrate findings from these conversations to hone policy solutions based on the needs of people.
• Continue to bring together diverse groups for their critical input and evaluation, including our Leadership Councils and Voices of Real Life.
• Assess the political feasibility and process for any solutions. Work with state and local stakeholders to determine the appetite for change at a local level and the process necessary to achieve those goals.
  • Evaluate the political environment in states, municipalities, and tribal governments to determine not only if change is feasible but also how best to achieve it.
• Identify places, people, and partner organizations to push solutions forward.
  • Creating proven success stories in environments ripe for change will help build the momentum necessary to create incremental change.
• Stay focused on the four goals moving forward and envision solutions through the lens of these goals. Everyone wants a more equitable, accessible, affordable, navigable, and personalized health care system. If a solution doesn’t build towards those goals, it is not solving a problem.