Andy Slavitt was working as an executive at United Healthcare 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 last 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. All together, 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 to implement and to 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 that 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 its 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
“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.”
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