Andy Slavitt was working as an executive at
Optum in 2013 when he was called in to be part of the team tasked with
repairing Healthcare.gov’s disastrous rollout, kicking off a two-year stint as
acting administrator of the Centers for Medicare and Medicaid Services. Five
years later, Slavitt is back in the private sector and again focused on fixing
America’s healthcare system, this time from outside the government.
In the past year he’s founded and launched
both a nonprofit (United States of Care) and a venture capital
firm (Town Hall Ventures). Next up? The Medicaid
Transformation Project, a plan to improve the way the 75 million Americans on
Medicaid receive treatment at some of the country’s largest hospital systems.
“When I left CMS, I launched an initiative in
three critical areas to basically say, we want to change the way healthcare
works in a decade,” says Slavitt. “I was 50 when I left. The question I ask
myself is by the time I’m 60, what do I want to be different?”
Slavitt is pulling together the CEOs of 17
hospital systems around the country to commit to improving care for their
Medicaid patients over the next two years in at least four areas: behavioral
health, women and infant care, substance use disorder as well as aiming to
reduce the number of preventable emergency department visits. The participating
hospital systems serve over half of the country’s Medicaid population across 21
states.
Many of the project’s partners already have
innovative programs in place to serve their Medicaid patients. For example,
Geisinger Health System, which serves northeastern and central
Pennsylvania, has something called a “Fresh Food Farmacy,” where doctors
can “prescribe” fresh fruits and vegetables to patients who have diabetes and
identify as being food insecure. A larger issue though, Slavitt says, is getting
these health systems to share that information with one another.
“When hotels started making WiFi free it
quickly spread to every hotel. Or when banks made ATMs more available, or you
could take a picture of your check and deposit it—those innovations don’t stay
proprietary for very long,” Slavitt says. “Healthcare unfortunately doesn’t
work that way.”
To improve that communication, Slavitt has
partnered with Chicago-based digital health firm Avia, which will help
implement and scale the digital efforts that these systems come up with. “The
most important thing about this is to get these organizations to commit to say
this is not about competition. It’s improving health for everybody,” Slavitt
says.
Slavitt says this project’s goals could range
from improving a Medicaid patient’s dialysis treatment experience to making
sure a patient can find the mental health help they need close to their home.
Avia would not comment on how much the project will spend to achieve these
goals, but all of the participating health systems are clients of Avia.
“With what’s happening in this nation right
now, there’s never been a more important time for us to focus in on this
population and to do that through a united front,” says Lloyd Dean, chief
executive of Dignity Health, which serves patients in California, Arizona and
Nevada. “We’re one of the most modernized countries in the world. I just think
it’s a right that people should have access to healthcare.”
A project like this, says Signe Peterson
Flieger, an assistant professor of public health and community medicine
at Tufts University, is part
of the larger trend of shifting toward value-based care, something that Slavitt
pushed during his time running CMS.
“I think there’s no doubt that we need to
emphasize both health needs and social service needs, and we should be thinking
about these collectively and not in silos,” Peterson Flieger says. “I think
we’re going to see more of this private sector saying,'We can do this with or
without the government.' ”
And the private sector has already started
doing that, separate from Slavitt’s efforts. Two of the country’s largest
health insurers, United Healthcare and Humana HUM +0.26%, recently announced that they have
spent $730 million on housing costs to help reduce the number
of avoidable visits to the emergency room. And of course there is the
still-unnamed J.P. Morgan -Amazon- Berkshire Hathaway BRK.B +0% venture that’s
aimed at improving the healthcare of the employees at those three
companies.
“I think people say the same thing about
healthcare: ‘Oh, we’ll never be able to control the cost. We’ll never be able
to deliver better care,’ ” Slavitt says. “The reality is, if you think big,
start small, and move fast you actually can.”
This post was updated to note that Andy
Slavitt was an executive at Optum, not United Healthcare in 2013.
Follow me on Twitter at @mtindera07.
Got a tip? Email me at mtindera@forbes.com
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