Everyone needs access to quality, affordable health care regardless of health status, social need or income.  To reach this paradigm shift, healthcare leaders must evangelize within industry and communities they serve.  There is a better path forward for American health care – one that is people-centered and transformational; however, to get there we must unite the power of one at the intersection of people, policy, and politics. By listening to people’s needs, jointly developing policy solutions, and partnering with others, we can ensure our health care system works for everyone.

This week on the Race to Value, we bring to you Natalie Davis and Dr. Venice Haynes at the United States of Care, a nonprofit organization focused on an ambitious goal to achieve universal access to quality and affordable healthcare for all Americans. It brings together stakeholders from various backgrounds, including healthcare experts, patients, policymakers, and advocates, to develop and implement practical, bipartisan solutions to improve the healthcare system in the United States. By fostering dialogue and collaboration, conducting research, and advocating for policies that enhance access, lower costs, and improve healthcare outcomes, the organization finds common ground and works across party lines and ideological divides to address the healthcare challenges facing the nation.

As CEO and Co-Founder of the United States of Care, Natalie Davis is on a mission to reshape and implement American health care policies that improves the lives of all people.  Dr. Venice Haynes, the Director of Research & Community Engagement for United States of Care, is a social and behavioral scientist focused on an overarching research agenda to address social determinants of health and health disparities in underserved populations using qualitative and community-based participatory approaches.  In this episode we talk about the tenets of patient-first care (a.k.a. value-based care) including affordability, dependability, personalization, and understandability.  We also have an in-depth conversation on the power of storytelling in health care transformation and the imperative to overcome structural barriers in the creation of health equity.

Episode Bookmarks:

01:30 United States of Care, a nonprofit organization focused on an ambitious goal to achieve universal access to quality and affordable healthcare for all Americans.

02:00 Introduction to Natalie Davis, Chief Executive Officer and Co-Founder.

02:45 Introduction to Venice Haynes, PhD, Director of Research & Community Engagement.

05:00 Natalie shares her personal story that led her towards an entrepreneurial career path in health care policy transformation.

07:30 Mentorship from Andy Slavitt and his advice to get out of Washington, D.C. to make an impact on health policy.

08:30 Venice discusses how her science and public health background inspired her to lead people-centered health care change.

11:45 Inspiration from Camara Phyllis Jones, a physician, epidemiologist, and anti-racism activist who specializes in the effects of racism and social inequalities on health.

14:30 When offered an alternative, by a 4:1 margin, people favor a model that compensates providers for improving overall health, delivering superior care, and coordinating patient care.

15:30 What it means for United States of Care to be at the intersection of people, policy, and politics in health care transformation.

16:00 Research and listening to people as a way to overcome tribalism and build an agenda of reform for the whole country!

16:45 The 4 goals and 12 solutions of United States of Care to meet the needs of people across demographics and can drive collection action to build a better health care system.

18:30 “The 4 goals of United States of Care – Affordability, Dependability, Personalization, and Understandability – comprehensively cannot be done in a fee-for-service model.”

19:00 The need to bring new health policy leaders into the value-based care movement (at the risk of the movement stalling out altogether for lack of emerging leadership).

20:00 Reframing the value-based care movement to the specific vocalized needs of constituents in the general public (instead of just payment models, quality measures, etc.)

21:00 “There is a resounding drumbeat in our community-focused value-based research — people want more whole-person care.”

22:30 Selectively using the right language when engaging communities (“using a new approach” instead of “reforming the system”).

23:00 Communities are overwhelmingly expressing their anger about the greed of the American healthcare system.

24:00 “When engaging our communities, language matters so very much. We must find the commonality in language to resonate with people.”

25:30 The storytelling project, “Voices of Real Life”, as a vehicle to galvanize healthcare experts, patients, policymakers, and advocates around a human-centered focus. 

26:00 Movements are led by effective storytelling and these stories can revitalize communities of people. (Is a social movement like civil rights or gay marriage any different than the movement for value-based care?)

27:30 The fear that people have in making large scale changes to American healthcare.

30:00 The importance of everyone feeling like they are a part of the change that is needed.  (Reframing health care failures from “individual” to “systemic.”)

31:00 Venice shares personal stories from her work with community focus groups and how people often feel alone when it comes to navigating health care challenges.

32:45 An example of poor maternal health care – a patient driving an hour for a prenatal checkup only to find that her doctor was not at that clinic on that day.

33:00 People often make life altering decisions over health care (e.g. marrying someone they don’t love, taking a second mortgage on their own).

34:00 People that are “satisfied” with their health care do not really exist! (They are just “satisfied” because they are one of the lucky ones with health insurance and access to care.)

37:00 Health Care Affordability and USofCare Poll showing 42% of voters have foregone health insurance in the past, and 41% of those under 30 have opted not to seek medical treatment in the last year.

38:00 Driving a multi-state approach to expanding coverage through public option.

39:00 “Affordability is always the #1 issue that comes up in our community conversations, regardless of the entry point where people enter the health care system.”

39:45 The breaking point of health care costs (e.g. federal deficits, employer cost shifting) and the levers that can be utilized to reign in costs through a public option.

40:30 The “hidden fees” passed on to patients by hospitals.

41:00 The different levers of change at the state level, and how they can impact change at the federal level.

41:30  The equity component to reforming health care costs at both an individual and societal level. (Check out the USofCare Health Equity Report)

42:00 Enhancing primary care access will lower overall health care costs in our country in the long-term.

43:00 Dependable healthcare coverage is an anchor in the storms of life, providing individuals and families the peace of mind that their health and well-being will be safeguarded in times of need.

43:45 More than 9 million people have been disenrolled by Medicaid redeterminationsresumed several months ago.

44:45 Common stories of people fearing lack of health care dependability (e.g. contractors, employees in the gig economy, pregnant women worried about repercussions from employers).

47:45 The challenge of health policies being written by people without the lived experiences of those directly impacted.

48:00 “Policy is nothing if not implemented well.”

49:00 The Texas Court Case (Braidwood v. Becerra) —  may cause nearly half of Americans (more than 151 million people ) the loss of access to free preventive services!

49:45 How the United States of Care is fighting to preserve the rights of Americans to retain their access to free preventive primary care. (See USofCare Preventive Services Resource Hub)

52:00 Personalized care to support to caregivers, improve mental health coverage, enhance maternal and newborn care, make care more convenient, and ensure that people can equitably access care virtually.

53:30 “We cannot reimagine health care with a one-size-fits-all approach.”

54:00 The work in Colorado to build a public option and culturally responsive networks.

55:30 How do we ensure that access to virtual care doesn’t exacerbate health inequities?

58:30 For people to get behind value-based care, we must relate to them at a personal level.

59:45 Speaking in terms of “quality over quantity” when personalizing the message of value-based care to patients.

60:00 Why “Value-Based Care” is such a poor choice of wording and causes confusion with patients.

62:00 A much-needed wave of patient consumerism is needed; however, the complexity of the system stifles innovation and creates a lack of understanding.

64:00 Natalie provides perspective on the need for community feedback on people-centered change in health care.

65:00 “We need to change the way we do change in health care.  This is not working!”

65:30 Can health care be as consumer-friendly as Uber or Chick-fil-A?

67:00 The importance of asking the right questions and engaging stakeholders before implementing a new technology innovation.

68:00 Creating trust in the system through co-creation and rightsizing of change management.

70:00 The amazing opportunity in engaging patient communities!

73:00 Support the work of United States of Care and follow Natalie on LinkedIn– “Be a part of the narrative change to follow the more systemic change that is necessary.”