Thanks to the Affordable Care Act (ACA), Millions of Americans now have access to health coverage and health care. However, with the excessive prices of healthcare, inconsistent quality in care delivery, overall systemic inefficiency, health inequities, and a lack of people-centered health care significant challenges still remain to be solved. With these challenges, there are financial concerns to how health care providers are going to be able to fix many of these problems that need to be addressed. Policymakers are worried that there’s going to be a shift in costs, where consumers are going to have higher insurance premiums and co-pays and benefits will be cutback in order to cover the costs.
In an era of health reform, how do we keep people at the center of our health system? Community Catalyst recently published a report, The Path to a People-Centered Health System, that answers this question. The report was designed to gather information on what consumer health advocates, those protecting and promoting the welfare and rights of health care consumers, are doing to transform the health delivery system. Community Catalyst consulted with consumer advocates from more than 40 states as well as a diverse group of other system stakeholders. “[They] wanted to understand what kinds of challenges consumer advocates will face as they become more fully engaged in this new phase of work, and what types of support will maximize their effectiveness.” This new phase of work is represented by the movement towards people centered care.
The report revealed some of the challenges with which consumer advocates are faced:
- Building and sustaining effective coalitions. Sometimes funder relationships and unique constituency needs or preferences make this challenging.
- Building capacity to conduct legal and policy research and analysis on financing and delivery system issues.
- Finding assistance and/or tools to help assess their political and market environment and prioritize “next steps.”
- Building a grassroots base of support and developing new consumer leaders.
- Finding advice and support to develop effective working relationships with other system stakeholders.
“Health system transformation is a long-term undertaking, and the needs of consumers and their advocates may shift over time,” says the report. “What we offer here are the building blocks for a durable foundation that will serve this work both now and into the future.” The building blocks are summed up in the following recommendations:
In order to first articulate a proactive vision and framework for a transformed health system, the report says that national groups must come together, along with state and local community advocates in order to shape a vision of what health system transformation would look like.
Strengthening and expanding coalition building at the state and local levels will allow for the creation of a shared framework that focuses outreach to those who represent or work with vulnerable populations–or in other words, those who have the most to gain from health reform.
Consumer advocates are faced with a significant learning curve when it comes to health system transformation and must build policy and delivery system expertise in order to engage in their work at the delivery system level.
Giving voice to the consumer experience is fundamental to making sure that consumers are getting the care that they need. The report recommends building–or strengthening existing–grassroots engagement and leadership development work. This connects consumer voices to the system.
Transformation also means establishing new kinds of working relationships with other system stakeholders. Consumers alone do not have the power to change the system and so it is important to build–or strengthen existing–stakeholder alliances.
The report also recommends building a communications program for use at all levels of advocacy that generates public support for health system transformation. This increase in public knowledge will allow consumers to better engage in conversations around challenges with the system and potential approaches to addressing them.
There are complex challenges that come with our healthcare system and consumer health advocates will need support. The report states that “[a]lthough they are at the center of the health system, consumers have been the least empowered.” It is hoped that these recommendations will offer a starting point for the next generation of consumer health advocates to change that and to ensure a health care delivery system that gets people the care that they need.
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