New Beginnings

Newtown, CT - December 29, 2017

Every new beginning comes from some other beginning’s end; or so the song says – Just about six and a half years ago I started a weekly missive aimed at synthesizing what I saw happening in the emerging field of alternative payment models and, more broadly, across the health care sector. The more frequently recurring themes centered on three elements: (1) our collective overriding imperative to improve the quality and affordability of health care so that all Americans could benefit from the best that U.S. healthcare has to offer; (2) it’s the incentives, stupid; and (3) how alternative payment models are designed has an indelible imprint on their results. I’ve summed up these last two points as form follows function and functions are driven by incentives. When designing alternative payment models (APMs) we must therefore be deliberate about the specific functions of the delivery system that we aim to improve. A recent report to which I contributed provides a good roadmap for those who want to approach the design and implementation of APMs with an eye to success, and another shows the perils of poor designs. The upshot is that, by now, the ingredients of success are known even though they are too often ignored. The original purpose of this missive may, as a result, have partially run its course while, at the same time, new courses have emerged.
What this means to you – Just about a year ago I announced that HCI3 had joined Altarum, a national non-profit whose mission is identical, and whose reach is far greater. As we close out 2017 and head into 2018, we do so with a beginning: Altarum’s new Center for Value in Health Care. The Center includes all of the former HCI3 staff and programs, and adds to it experts in patient engagement, health care economics, advocacy and other disciplines that will, we hope, help achieve even greater system change to bring about our collective overriding imperative. It is therefore from the new Center that this weekly missive will be sent and to which others in the Center will contribute to offer their unique perspectives on the important issues that affect us all and the solutions that we must apply to them to bring about lasting change. We will remain faithful to separating the wheat from the chaff and calling out things as they are, even when the truth is uncomfortable to many. Our obligation has been, is, and always will be to the people of the United States who, today, pay at least twice as much for their health care as anyone else in the world and fail to get any more out of it than they do. Many continue to be crushed by repressive premiums and out-of-pocket expenses, lost in the darkness of price and quality opacity, and harmed by a system that should always heal. Our mission stays the course, and this new beginning, while also being the end of a six and half year-old beginning, is the compass to which we will steer. And to all who share this mission, peace and best wishes for 2018.