Copyright Forbes
When it comes to creating a national healthcare system that truly serves everyone, too many people focus exclusively on the challenges and obstacles. While the challenges are real, I see opportunities. I know that the traditional metrics of a “healthy” healthcare system—accessibility, affordability, and strong patient outcomes—are not good when we compare the U.S. to other developed countries. The U.S. Department of Health & Human Services reports that 1 in 10 Americans still don’t have health insurance. Americans now spend more on healthcare than on groceries or housing. A 2024 study from the Commonwealth Fund reveals that Americans live the shortest lives and have the most avoidable deaths compared to other peer nations. I’ve dedicated my career to advocating for innovative solutions to how we deliver healthcare. Through my work, I’ve seen that the policies and interventions that have brought us to this point were inspired by big ideas and bold actions. They’ve laid the foundation for a system of healthcare. But they are steps that have propelled us forward, not barriers to advancing further. Conversations about healthcare in this country are quickly politicized. But when we focus on outcomes, it’s a lot easier to find clear areas of agreement: preventive care that catches issues before they become critical; consistent, comprehensive care management; a close relationship between patient and provider; reduced overall healthcare costs through early intervention; improved patient outcomes and quality of life. So, how do we do this? We achieve this by measuring the quality of care not in terms of procedures or tests, but in the health and wellness of patients and communities. By shifting from expensive reactive care to preventive care. By building collaborative and integrated teams equipped to deliver personalized plans for healthier living. That’s why I advocate for value-based care, and for an Accountable Care Organization (ACO) model to deliver it. Look again at those traditional metrics of accessibility, affordability, and outcomes. The current fee-for-service system rewards volume over value and complexity over outcomes, and fails to truly prioritize patient health. ACOs have the potential to completely restructure how we deliver healthcare, making it more patient-centered, cost-effective, and responsive to individual needs. If the goal is to create a healthcare system that is less complex, more supportive, and genuinely focused on keeping patients healthy, ACOs offer a clear path forward. Let’s start with the data. ACOs participating in Medicare Shared Savings Programs and Innovation Center models have consistently demonstrated their ability to deliver high-quality care while generating meaningful savings. The Congressional Budget Office has found that physician-led ACOs, particularly those with a strong primary care focus, generate the most significant savings. But it's their holistic approach to healthcare that I find most impressive. ACOs focus on comprehensive, team-based care that addresses a patient’s entire health ecosystem, integrating services that have traditionally been siloed, leveraging care teams that incorporate social workers, dietitians, pharmacists, and behavioral health specialists to deliver care that moves beyond treating medical conditions to address social determinants of health, including food insecurity and housing challenges. The path to widespread value-based care adoption isn’t without challenges. But my proposal centers on four critical pillars to strengthen value-based care: Full risk-sharing options. By holding providers accountable for total patient care, we create genuine incentives for comprehensive, preventive healthcare. Upfront capitated payments. These payments provide the financial stability needed to invest in comprehensive care infrastructure, particularly in underserved communities. Financial predictability. Providers need stable, transparent payment models to make long-term investments in patient care. Sustainable payment formulas. We must move away from models that punish success through what we call the “ratchet effect,” where previous efficiency automatically reduces future benchmarks. ACOs represent a return to a more personal model of healthcare, when doctors knew patients throughout their lives and genuinely cared about their health outcomes. ACOs can help reestablish those meaningful patient-provider relationships.
