Earlier this year, Costs of Care, a nonprofit organization dedicated to curating and broadly disseminating insights from the front lines of health care to help delivery systems provide better care at lower cost, launched its Affordability Moonshot, an ambitious movement to drive solutions to improve the affordability of health care. In the following Q&A, Jordan Harmon, MHA, Costs of Care’s Director of Advocacy, discusses the origins and goals of the Moonshot.
Choosing Wisely: What is the Affordability Moonshot?
JH: Nearly everyone who receives health care in the United States is at risk of receiving care that is so expensive it threatens their financial security. Thousands of stories highlight the difficult decisions patients are forced to make every day – “my life, or my life savings.” At Costs of Care, we decided to take the lead on changing this story by launching our Affordability Moonshot, declaring “we envision a world in which nobody has to choose between their life and their life savings.” We look to create this world by establishing our Affordability Accelerator, in which we will convene influential experts and stakeholders to work together on developing, testing, and implementing the most promising high-impact and sustainable interventions to improve patient affordability.
CW: Costs of Care has a great track record in addressing financial toxicity in health care. What’s different about this initiative and why did you launch it?
JH: This is undoubtedly the largest, most complex issue that Costs of Care has sought to address. We began more than 10 years ago as an advocacy and social venture organization, curating stories from patients with crippling medical bills and highlighting the negative impact of these bills. We worked with frontline clinicians and organizations, like the ABIM Foundation, to take those stories and help create a culture of medicine that incorporates value-based health care. As the years have passed, we’ve come to understand that beyond the necessary principles of value-based health care, the issue of affordability predominantly impacts patients and their families. Now is a critical time to bring together the right stakeholders to work toward innovative solutions in areas of clinical care, billing, and financial assistance to improve patient affordability.
CW: Can you explain your Affordability Framework and how health systems can best incorporate it into their operations?
JH: The Affordability Framework was recently published in NEJM Catalyst as a way to start the conversation about addressing affordability in health system environments. We understand this is a complex issue that has many moving parts – including reimbursement and regulatory barriers. However, there are key concepts that every health system can implement today that will both improve affordability for patients and allow those health systems to be more competitive in their markets. No single solution will work for every health system, but we provide a few examples within the framework.
CW: What are the biggest challenges to achieving your goals?
JH: The biggest challenge to improving affordability in health care is complexity. There is little evidence that guides payers, providers, and consumers about how to make care more affordable. Solutions will not be “one size fits all” – they will depend on the type of organization, geography, patient population, and so on. That being said, Costs of Care is excited to take the lead on helping to navigate these complexities with partners dedicated to improving patient affordability.
CW: What early successes do you see as achievable?
JH: Some of the low-hanging fruit are laid out in the Affordability Framework, which aims to pragmatically address patient affordability. We believe the components at the core of improving affordability are: developing meaningful, actionable out-of-pocket cost and payment information for patients; investing in clinical training on affordability; developing clinical and financial pathways; and delivering care through lower cost/higher quality sites. These are ways that health systems and payers can begin to successfully address affordability today, and with further piloting of interventions developed from our Affordability Accelerator, we look to further these successes so that no one has to choose between their life and their life savings.