As the House and Senate get close to releasing their versions of comprehensive payment and delivery reform legislation, the Campaign For Better Care, with the help of students from the Harvard School of Public Health, will be doing a series of blog posts this week highlighting our 10 Principles for Better Care.
3. Consumer Voice: Individual health care consumers are the heart of the care system, and must have a strong voice in the design and governance of the payment reform structures. Consumers should be represented on any state implementation board, as well as in the governance of Accountable Care Organizations (ACOs) and/or other payment intermediaries.
All too often, consumers are left out of the most important conversations concerning health care. If the most basic goal of health care is patient health and welfare, it only makes sense that patients should have a voice in how it is run. Patient and patient advocates represented within state health care regulatory and oversight bodies will ensure value and protections for the consumers of health care.
- The state oversight board or entity should have at least both a patient and a consumer health organization representative. An actual or potential recipient of health care who has demonstrated a commitment to ensuring that patients are protected in the health care system should hold seats in state regulatory boards, and should have an active role in both regulation design and oversight.
- Members of the oversight board entity must not have financial conflicts of interest in the health care system including representatives of insurers, medical organizations or hospitals. One of the reasons the Massachusetts Health Connector has been so effective is because no group with a direct financial interest in their work participates in the Board. Representatives with financial conflicts of interest will impair the state’s ability to fairly regulate the health care industry.
- Every ACO and other payment and delivery entity must have a patient representative on its board or governance structure. Examples of patient representatives within such entities have been very successful. The Commonwealth Care Alliance, an ACO-like provider in Massachusetts, includes patient representatives in its governance. Since 2008, hospitals have additionally been required to consult with patient and family advisory councils.
Patients having an active role within health care reform and regulation will protect and advance the interests of all consumers. These simple and obvious proposals will ensure that in Massachusetts, patients come first.
Better care means listening to the consumer voice.
-Akash A. Desai