Community Catalyst has published this policy platform for health system transformation from a health consumer perspective. When using the framework of the “triple aim”, consumers should be asking:
- whether “better care” focuses on improving care for people with multiple chronic conditions and disabilities who account for the bulk of our national health care spending and who are often poorly served, and low-income people, racial and ethnic minorities and other marginalized populations
- whether “better health” includes redirecting wasted resources in an inefficient medical care system to improve the social and economic conditions that generate a lot of acute and chronic health spending
- whether “better value” addresses those features of the U.S. health care financing and delivery system that inflate our spending relative to other advanced industrial democracies but fail to improve clinical outcomes.
The policy platform includes six components:
- Structures for meaningful consumer engagement to ensure that people have a voice in policy decisions, the health care organizations that serve them and their own health care, including advisory councils and engagement of patients as part of clinical care.
- Payment arrangements that incentivize people-centered health care by paying providers for achieving the health outcomes that matter most, ensuring that providers are appropriately compensated for the care of complex patients, and reducing patient barriers to accessing needed care.
- Resources for community and population health in order to address the social and economic factors affecting the health of people in their communities, including the use of community benefit programs to reflect and target community needs and priorities, the improved alignment of community resources, an increased investment in prevention, and robust evaluation of population health outcomes.
- Consumer protection through the application of strong safeguards including independent and effective ombudsman programs, consumer-centric quality measures, transparency, and consumer choice.
- Person-centered culture of care through the adoption of care models and best practices that meet the specific goals, preferences and needs of the population being served, including at the end of life, coordinated care, and integration of physical health, behavioral health and community supports and services.
- Health equity for underserved populations in all health system transformation efforts, expanding the collection and reporting of data on disparities, ensuring that care improvement efforts specifically address health disparities, and promoting a culturally competent workforce, including the use of community health workers.